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Case Reports
. 2012;4(1):e2012068.
doi: 10.4084/MJHID.2012.068. Epub 2012 Nov 5.

Multiple myeloma and paget disease with abnormal skull lesions and intracranial hypertension

T Caravita  1 , A Siniscalchi, E Montinaro, R Bove, M Zaccagnini, D De Pascalis, A Morocutti, L Brusa, F Arciprete, Ml Cupini, A Perrotti, E Palma, S Fratoni, R De Simone, C Iani, P de Fabritiis
Affiliations
Case Reports

Multiple myeloma and paget disease with abnormal skull lesions and intracranial hypertension

T Caravita et al. Mediterr J Hematol Infect Dis. 2012.

Abstract

We report a 73 years old man with a diagnosis of Paget Disease (PD) and symptomatic Multiple Myeloma (MM). Coexistence of MM and PD has rarely been described. PD mimics many of the features of bone destructive process in MM, making differential diagnosis more complicated. In addition, the presence of serious muscolo-skeletal and metabolic complications in both diseases makes management of patients difficult, worsening the prognosis.The comparison of these two diseases has led to the characterization of a common molecular mechanism represented by the receptor activator of nuclear factor-kB ligand (RANKL)/Osteoprotegerin signaling pathway. The improved comprehension of these mechanisms led to the development of new pharmacologic agents (bisphosphonates, cytokines inhibitors) effective for the treatment of these bone diseases.

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Figures

Figure 1
Figure 1
Skull lesions imaging. Presence of skull tumors over the right frontal and parieto-occipital regions.
Figure 2
Figure 2
Cranial MRI. Evident eso-endophytic mass lesions through the skull with contrast enhancement and brain parenchima compression.
See this image and copyright information in PMC

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