Skip to main content

Advertisement

SpringerLink
Log in

Sclerotic multiple myeloma with an unusual sunburst periosteal reaction occurring in the sternum

  • Case Report
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Multiple myeloma is a disseminated neoplastic monoclonal gammopathy that usually affects the skull, clavicle, rib, pelvis, spinal column, and proximal portions of the humerus and femur. The initial manifestation of multiple myeloma in the sternum is rare. The classic radiological presentations of multiple myeloma are multiple “punched-out” areas of bone destruction, expansile lytic lesions, and generalized osteoporosis. Primary sclerotic presentation is rare and occurs in only 3 % of cases. A sclerotic multiple myeloma with a sunburst periosteal reaction occurring in the sternum has not been reported in the English literature. We report a case of sclerotic multiple myeloma of a 49-year-old woman. In the sternum, the lesion displayed extensive sclerosis mixed with mottled lytic areas with a sunburst periosteal reaction occurring in the periphery, which radiologically mimicked an osteosarcoma. Multiple focal areas of sclerosis were also found in the right clavicle, pelvis, multiple ribs, and vertebrae.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. Ghosh S, Wadhwa P, Kumar A, Pai K, Seshadri S, Manohar C. Abnormal radiological features in a multiple myeloma patient: a case report and radiological review of myelomas. Dentomaxillofac Radiol. 2011;40(8):513–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Baykul T, Aydin U, O Carroll MK. Unusual combination of presenting features in multiple myeloma. Dentomaxillofac Radiol. 2004;33(6):413–9.

    Article  CAS  PubMed  Google Scholar 

  3. Shozushima M, Suzuki M, Ito S, et al. Multiple myeloma with a distinct “sun-ray appearance” occurring in the jaw. Oral Radiol. 1987;3(2):121–6.

    Article  Google Scholar 

  4. Mohammadi A, Ilkhanizadeh B, Ghasemi-Rad M. Mandibular plasmocytoma with sun-ray periosteal reaction: a unique presentation. Int J Surg Case Rep. 2012;3(7):296–8.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Ramon Y, Oberman M, Horowitz I, Freedman A, Tadmor R. A large mandibular tumor with a distinct radiological “sun-ray effect” as the primary manifestation of multiple myeloma. J Oral Surg. 1978;36(1):52–4.

    CAS  PubMed  Google Scholar 

  6. Porter EC. Osteogenesis in multiple myeloma. Report of a case. Radiology. 1961;76:457–8.

    Article  CAS  PubMed  Google Scholar 

  7. Lipper S, Kahn LB, Hesselson N. Localised myeloma with osteogenesis and Russell body formation. S Afr Med J. 1975;15(49):2041–5.

    Google Scholar 

  8. Grover SB, Dhar A. Imaging spectrum in sclerotic myelomas: an experience of three cases. Eur Radiol. 2000;10(11):1828–31.

    Article  CAS  PubMed  Google Scholar 

  9. Langley GR, Sabean HB, Sorger K. Sclerotic lesions of bone in myeloma. Can Med Assoc J. 1966;94(18):940–6.

    PubMed Central  CAS  PubMed  Google Scholar 

  10. Schulze M, Weisel K, Grandjean C, et al. Increasing bone sclerosis during bortezomib therapy in multiple myeloma patients: results of a reduced-dose whole-body MDCT study. AJR Am J Roentgenol. 2014;202(1):170–9.

    Article  PubMed  Google Scholar 

  11. Blaquière RM, Guyer PB, Buchanan RB, Gallagher PJ. Sclerotic bone deposits in multiple myeloma. Br J Radiol. 1982;55(656):591–3.

    Article  PubMed  Google Scholar 

  12. McCluggage WG, Jones FG, Hull D, Bharucha H. Sclerosing IgA multiple myeloma. Acta Haematol. 1995;94(2):98–101.

    Article  CAS  PubMed  Google Scholar 

  13. Nakanishi K, Kashiwagi N, Hamada K, Yaqi T, Tomita Y. Solitary plasmacytoma of the sternum detected incidentally by MR imaging of the cervical spine. Magn Reson Med Sci. 2010;9(4):227–31.

    Article  PubMed  Google Scholar 

  14. Jiang ZH. Radiologic diagnosis of tumors of the sternum (analysis of 30 cases). Zhonghua Fang She Xue Za Zhi. 1988;22(5):286–9.

    CAS  PubMed  Google Scholar 

  15. Bloom RA, Libson E, Husband JE, Stoker DJ. The periosteal sunburst reaction to bone metastases. A literature review and report of 20 additional cases. Skeletal Radiol. 1987;16(8):629–34.

    Article  CAS  PubMed  Google Scholar 

  16. Rana RS, Wu JS, Eisenberg RL. Periosteal reaction. AJR Am J Roentgenol. 2009;193(4):W259–72.

    Article  PubMed  Google Scholar 

  17. Restrepo CS, Martinez S, Lemos DF, et al. Imaging appearance of the sternum and sternoclavicular joints. Radiographics. 2009;29(3):839–59.

    Article  PubMed  Google Scholar 

  18. Khanna L, El-Khoury GY. SAPHO syndrome–a pictorial assay. Iowa Orthop J. 2012;32:189–95.

    PubMed Central  PubMed  Google Scholar 

  19. Ji ZF, Zhang DY, Weng SQ, Shen XZ, Liu HY, Dong L. POEMS syndrome: a report of 14 cases and review of the literature. ISRN Gastroenterol. 2012;2012:584287. doi:10.5402/2012/584287.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Tamir R, Glanz I, Lubin E, Vana D, Pick AI. Comparison of the sensitivity of 99mTc-methyl diphosphonate bone scan with the skeletal X-ray survey in multiple myeloma. Acta Haematol. 1983;69(4):236–42.

    Article  CAS  PubMed  Google Scholar 

  21. Reitan JB, Pape E, Fosså SD, Julsrud OJ, Slettnes ON, Solheim OP. Osteosclerotic myeloma with polyneuropathy. Acta Med Scand. 1980;208(1–2):137–44.

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, 139 Ziqiang Road, Shijiazhuang City, 050051, Hebei Province, China

    Yuqing Li, Wenjuan Wu, Zekun Zhang & Mahrukh Latif

  2. Department of Pathology, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang City, Hebei Province, China

    Yang Ding

Authors
  1. Yuqing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wenjuan Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zekun Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yang Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mahrukh Latif
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuqing Li.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, Y., Wu, W., Zhang, Z. et al. Sclerotic multiple myeloma with an unusual sunburst periosteal reaction occurring in the sternum. Skeletal Radiol 44, 749–754 (2015). https://doi.org/10.1007/s00256-014-2036-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-014-2036-x

Keywords

Search

Navigation