Clinical Report: Comprehensive Imaging Assessment for Diagnosing Renal Involvement in Multiple Myeloma

Background

Renal involvement in multiple myeloma is an uncommon extramedullary disease that poses significant diagnostic challenges. The lack of specific clinical symptoms and typical imaging manifestations often leads to misdiagnosis as primary renal carcinoma or other retroperitoneal neoplasms. Understanding the imaging characteristics is crucial for improving early recognition and management of this condition. The reported incidence of renal involvement in multiple myeloma is low, and its clinical manifestations can be subtle, complicating diagnosis.

Data Highlights

Case study of a 67-year-old male with renal involvement in MM diagnosed via multimodal imaging, including ultrasound, CT, and PET-CT, which were critical in identifying the extent of the disease.

Key Findings

• Multimodal imaging, including ultrasound, CT, and PET-CT, was essential for accurate diagnosis and assessment of renal involvement.
• The patient was diagnosed with light-chain MM (Durie-Salmon Stage IIIB, R-ISS Stage III high-risk).
• Imaging revealed extensive invasion of the left renal lesion and significantly decreased renal function.
• Pathological biopsy confirmed the diagnosis of anaplastic plasma cell tumor.
• The patient received multi-line chemotherapy but died of severe infection five months post-diagnosis.

Clinical Implications

The case highlights the role of multimodal imaging techniques in the diagnosis of renal involvement in multiple myeloma, which can help clarify the extent of disease and inform treatment decisions.

Conclusion

Accurate imaging is critical for diagnosing renal involvement in multiple myeloma, which can lead to better understanding of this rare condition.

Related Resources & Content

1. Diagnostic Imaging Techniques for Evaluating Renal Tumors and Assessing Treatment Response, 2018 -- Springer
2. Utilizing Radiomics and Machine Learning for the Evaluation of Renal Tumor Subtypes via Multiphase CT, 2024 -- Springer
3. Prognostic and Clinical Implications of Bone Marrow Abnormalities in Multiple Myeloma Patients, 2015 -- Nature
4. Improvement in renal function and its impact on survival in patients with newly diagnosed multiple myeloma, 2015 -- Nature
5. EHA–EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma, 2025 -- Nature Reviews Clinical Oncology
6. Therapeutic options for extramedullary involvement in multiple myeloma, 2025 -- Clinical and Experimental Medicine
7. EHA–EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma | Nature Reviews Clinical Oncology
8. Therapeutic options for extramedullary involvement in multiple myeloma | Clinical and Experimental Medicine | Springer Nature Link