Written informed consent was obtained from the patient to
publish this report in accordance with the journal’s patient consent
policy
Abstract Multiple Myeloma (MM) is a malignant plasma cells
disorder that account for the 15% of hematologic malignancies. The
clinical manifestation is defined by the presence of anemia, renal
failure, hypercalcemia and osteolytic bone lesions called with the
acronym CRAB. Here we describe the case of a caucasian man referred to
our Center for a clinical suspicion of MM. A comprehensive work-up,
including blood tests, radiological examinations and bone marrow biopsy
ruled out the presence of plasma cells neoplasm Further investigations
as CT guided-biopsy of a lytic lesion allowed us to perform a diagnosis
of brown tumor (BT), a tumor-like lesion due to the bone remodeling
process in prolonged hyperparathyroidism. This diagnosis was confirmed
by endocrinological evaluations followed by a parotidectomy with
resolution of the clinical manifestations. Our case outlines the
importance of an accurate differential diagnosis in the suspicion of MM,
because the concomitant occurrence of comorbidities and illnesses may
confound the evaluation, In particular the combination of anemia,
peripheral neuropathies and renal impairment could be associated to a
number of other causes and it is mandatory a thorough anamnesis,
clinical and instrumental examination and laboratory investigations to
rule out other etiologies.