Introduction.
Multiple Myeloma (MM) is a neoplastic disorder due to the proliferation of clonal plasma cells that account for the 15% of the hematological neoplastic tumors1,2. The symptomatic phase of this neoplasm is characterized by the presence of one or more of the following signs and/or symptoms: anemia (hemoglobin psitroalue of < 2 g/dl below the lowest limit of normal, or a hemoglobin value < 100 g/L), hypercalcemia (serum calcium >1 mg/dL higher than the upper limit of normal or > 11 mg/dL), renal failure (creatinine cleareance < 40 mL per min or serum creatinine > 2mg/dL) and bone lesions (one or more osteolytic lesions on skeletal radiography, Computer Tomography (CT), or Positron Emission Tomography-CT (PET-CT). This cohort of signs and symptoms is historically defined with the acronym of CRAB3. However, particularly in the elderly patients, these clinical manifestations are very frequent and could be caused by other diseases than MM. The concomitant presence of other pathologic conditions could led to a misdiagnosis with dramatic consequences for the patients. Here we present the case of an adult Italian patient with signs and symptoms coherent with suspicion of MM.