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Case report
Advanced myeloma masquerading as chronic shoulder pain in a 48-year-old man: a diagnostic dilemma
  1. Rajarshi Bhadra1,
  2. Teodora Nikova2,
  3. Meyappan Somasundaram1 and
  4. Keyvan Ravakhah1
  1. 1Internal Medicine, St Vincent Charity Medical Center, Cleveland, Ohio, USA
  2. 2Internal Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA
  1. Correspondence to Dr Rajarshi Bhadra; drrajarshibhadra{at}


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.

  • cancer - see oncology
  • renal system
  • malignant disease and immunosuppression
  • monoclonal gammopathy of undetermined significance associated neuropathy

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  • Contributors RB was involved in planning, conduct, reporting, conception and design, acquisition of data and interpretation of data; he was also directly involved in patient care right from admitting the patient as well as writing the manuscript. TN has been involved in the literature review and drafting of the manuscript. MS was primary attending under whose care the patient was admitted. He was involved in overall foreseeing the data, critical input and recommendations as needed and was involved in the literature search as well. KR was involved in clinical decision-making while taking care of the patient .Overall literature review and managing the final texture of the article can be attributed to his credit.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.