CTICasesExtraosseous (Extramedullary) Multiple Myeloma with Paraspinal and Soft-Tissue Masses
Imaging findings
On the same CT, multiple additional soft-tissue masses are identified in the paraspinal region, upper abdomen, extrapleural space, and breast, most showing high attenuation and having developed over a short interval; adjacent vertebral bodies show a porous, lytic appearance with associated rib fractures.
Key takeaways
Multiple rapidly developing, high-attenuation soft-tissue masses in a patient with multiple myeloma -- including paraspinal, extrapleural, and even breast locations -- represent extraosseous (extramedullary) plasma cell deposits rather than a separate malignancy or infection, and myeloma should be considered whenever new soft-tissue masses appear in a patient with a known plasma cell dyscrasia, even in unusual locations like the breast.
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