Multiple Myeloma Mimicking Bone Metastasis from Breast Cancer: Report of a Case

Tomono, Hitoshi; Fujioka, Susumu; Kato, Kenji; Yoshida, Katue; Nimura, Yuji

doi:10.1007/s005950050339

Cited by 5 publications

(6 citation statements)

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“…There are many reports demonstrating mimicking bony lesions on bone scan in patients with infectious and inflammatory diseases, and cancers including breast cancer [6][7][8][9]. But no reports demonstrate mimicking osseous metastasis in ribs on bone scan in patients with breast cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Bone scan for osteoblastic metastatic lesions is highly sensitive but not specific. False positive findings of bone scan result from microcalcification of soft tissue cancers, benign bone neoplasm, bone fracture, healing osseous trauma, and osteomyelitis [4][5][6][7][8]. In this case report, we describe a patient with a 20 year history of breast cancer who presented with symptomatic chest signs.…”

Section: Introductionmentioning

confidence: 95%

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Pulmonary Metastasis on TC-99m MDP Bone Scan Mimicking Metastatic Rib Lesions in Breast Cancer

Cao

Heath²,

Liang³

et al. 2014

J Nucl Med Radiat Ther

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Bone scan has been widely employed to detect osteoblastic bone metastasis because of the imaging technique's high sensitivity. However, care should be taken to distinguish false positive bone lesions which result from microcalcification of soft tissue malignancy with real osseous metastasis by correlating other modalities of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). We report, for the first time, a patient who was initially diagnosed with stage II left breast infiltrating ductal carcinoma and was under clinical management for 20 years. The patient subsequently presented with thoracic symptoms. Bone scan showed multiple focal uptakes within bilateral thoracic ribs. FDG PET/CT scans, however, showed numerous metabolically active bilateral pulmonary nodules with no osseous lesions in ribs. This case demonstrates abnormal findings on bone scans mimicking metastatic rib lesions from micro-calcified pulmonary metastatic nodules in a patient with breast cancer. Thus, care should be taken to correlate interpretation of high sensitivity but non-specificity bone imaging with other modalities such as FDG PET/CT. Keywords:Whole body bone scan; FDG PET/CT; Breast cancer; Pulmonary metastasis; Bony metastasis SummaryTc-99m MDP whole body bone scan is very sensitive and widely applied for clinical staging, monitoring therapeutic response, and evaluating malignant tumor recurrence in patients with malignant cancers, specifically breast cancer in female patients, prostate cancer in male patients, and other cancers including pulmonary cancers. However, attention should be paid by clinicians when they dictate bone imaging given that the various false positive findings may diminish specificity of the study. We presented a case for the first time that demonstrates abnormal findings on bone scans mimicking metastatic rib lesions from micro-calcified pulmonary metastatic nodules in the patient with breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Pulmonary Metastasis on TC-99m MDP Bone Scan Mimicking Metastatic Rib Lesions in Breast Cancer

Cao

Heath²,

Liang³

et al. 2014

J Nucl Med Radiat Ther

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“…There are few cases reported in the literature which showed multiple myeloma in known case of breast carcinoma 11,12 . The present case clinically thought as multiple myeloma turned out to be metastatic deposits of breast carcinoma.…”

Section: Case Reportmentioning

confidence: 99%

Metastatic Breast Carcinoma With Multiple Osteolytic Lesions - A Diagnostic Dilemma

Aruna¹,

Manimekhala²,

Rahman³

et al. 2014

jemds

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Bone is one of the common sites for distant metastasis from breast cancer. About 6%-10% of breast carcinomas have already spread to distant sites at the time of initial diagnosis. Presence of bone metastasis affects patient's prognosis and the planning of treatment. We report a case of 32year old female who presented with a subtrochanteric fracture left femur and multiple osteolytic lesions throughout the axial skeleton leading to clinical suspicion of multiple myeloma. Hematological work up suggested a metastatic deposit. Subsequent detailed examination revealed a breast lump in right breast. On core biopsy it was diagnosed as duct cell carcinoma. This report addresses the role of bone marrow examination in arriving at a diagnosis in multiple osteolytic lesions which pose wide differential diagnoses.

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“…3,11,12 Still, the symptoms of relapse of breast carcinoma after a prolonged remission period should arouse suspicion about other secondary diseases such as HPD, primarily multiple myeloma (MM). [11][12][13][14] Suspicion of multiple myeloma is related to the occurrance of changes in bones without signs of extraosseous metastases. 13 Also, the occurrance of secondary leukemias was observed to follow the treatment of various epithelial malignant tumors.…”

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confidence: 99%

Malignant epithelial tumors and hematologic malignancy

Marković-Glamočak

Sučić

Ries

et al. 2008

Diagnostic Cytopathology

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The aim of this study was to analyze the value of cytology in differentiation between malignant epithelial tumor metastases and hematologic malignancy. The follow-up of ten (10) patients who underwent diagnosis and treatment of two malignant diseases, i.e. carcinoma and hematologic malignancy, was performed in the 2000-2005 period. The median of age of our patients was 72 years (range: 49-79). Cytological examination included epithelial tumors, lymph nodes and bone marrow standard Pappenheim and immunocytochemically stained smears. Carcinoma was initially diagnosed in 40% (4/10) patients and hematologic malignancy in 50% (5/10) patients, while both diseases co-occurred in one patient (1/10). Most of hematologic malignancy cases (4/10) were diagnosed as lymphoma. Multiple myeloma was diagnosed in 3 out of 10 patients (30%). Individual cases of acute myeloblastic leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia were diagnosed in the remaining three patients. Most carcinomas were breast cancer (8/10), while prostate and thyroid gland cancer were diagnosed each in one patient, respectively.

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Multiple Myeloma Mimicking Bone Metastasis from Breast Cancer: Report of a Case

Cited by 5 publications

References 0 publications

Pulmonary Metastasis on TC-99m MDP Bone Scan Mimicking Metastatic Rib Lesions in Breast Cancer

Pulmonary Metastasis on TC-99m MDP Bone Scan Mimicking Metastatic Rib Lesions in Breast Cancer

Metastatic Breast Carcinoma With Multiple Osteolytic Lesions - A Diagnostic Dilemma

Malignant epithelial tumors and hematologic malignancy

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