Hepatic and renal plasma cell lesions in a patient with multiple myeloma in hematological remission

Plasma cell myeloma is characterized by plasma cell infiltrations, the presence of paraprotein and mostly skeletal destruction with osteolytic lesions. Liver or kidney infiltration has been described in patients with end stage multiple myeloma (MM), while the features of this malignant dissemination is not clearly understood. An atypical form of MM relapse is presented in a patient being in bone marrow remission, with simultaneous lesions in liver, kidney and suspicion of brain involvement. This case is an interesting model of refractory MM extraosseous involvement, that a clinician should be aware of when carrying out differential diagnosis.