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Papers of the Week

2020 May 27

BMJ Case Rep



Advanced myeloma masquerading as chronic shoulder pain in a 48-year-old man: a diagnostic dilemma.


Bhadra R, Nikova T, Somasundaram M, Ravakhah K
BMJ Case Rep. 2020 May 27; 13(5).
PMID: 32467114.


Although solitary plasmacytomas may occasionally present as collar bone swellings or fractures, multiple myeloma involving clavicle is extremely rare. Ten to forty per cent of multiple myeloma cases are asymptomatic and are incidental diagnoses. Our case report describes an entirely benign presentation like chronic shoulder pain masquerading advanced myeloma, thereby posing a significant diagnostic dilemma. We present a 48-year-old man who presented with chronic bilateral shoulder pain with no history of trauma and was eventually diagnosed with advanced multiple myeloma and pathologic fracture of the right clavicle. It is, therefore, evident that a low threshold for suspicion can lead to early diagnosis and initiation of treatment and better survival.