The Hidden Enemy: A Case Report on an Uncommon Variant of Non-Secretory Myeloma

Multiple myeloma is a malignant proliferation of plasma cells producing a monoclonal paraprotein. Multiple myeloma can present in a wide range of ways for example hypercalcaemia, hyper viscosity, renal failure and bone pains/fractures. We report a case of non-secretory multiple myeloma presented with only symmetrical recurrent joint swelling. This patient had no other symptoms and his serum basic biochemical analyses were normal. He had normal serum protein in electrophoresis and negative for urine Bence jones protein. Histologically, loosely arranged clusters of plasmacytoid cells are seen which were CD138 positive, confirming the diagnosis of non-secretory plasma cell myeloma. To diagnose cases of multiple myeloma with normal serum electrophoresis, a high index of suspicion is needed.