Multiple myeloma in a patient with suspected hyperparathyroidism

Multiple myeloma (MM) is a clonal B-lymphocyte neoplasm of terminally differentiated plasma cells. Imaging modalities which allow the recognition of the effects of myeloma cells on the skeletal system have been utilized for a long time. Herein, we represent a patient with generalized osteoporosis and hypercalcemia, who was referred for parathyroid scan, in whom the widespread bone marrow technetium-99m-methoxy-2-isobutylisonitrile (99mTc-MIBI) uptake suggested the presence of a bone marrow involving pathology, which turned out to be multiple myeloma on bone marrow biopsy. The current case report highlights the importance of 99mTc-MIBI scintigraphy, with a relatively low cost and better accessibility compared with other high sensitivity modalities such as PET-CT, to be used to demonstrate multiple myeloma bone marrow involvement, which could incline physicians to consider 99mTc-MIBI scintigraphy as a complementary diagnostic tool for multiple myeloma.