• C Fery-Blanco, C Prati, P Ornetti, J Bevalot, G Streit, E Toussirot, and D Wendling.
• Service de Rhumatologie, CHU Jean-Minjoz, boulevard Fleming, 25000 Besançon cedex, France.
• Rev Med Interne. 2007 Jul 1; 28 (7): 504-6.

IntroductionMultiple myeloma and primary hyperparathyroidism are two causes of hypercalcemia. This association has already been described to be not casual, despite their link is still unknown.ObservationWe describe a 68 years old woman, without notable background, was admitted for low back pain. Biology showed an IgG Kappa multiple myeloma (stade 3) and an hypercalcemia without renal failure. Hypercalcemia was difficult to control with bisphosphonate and calcitonin. At first, there was also an hypophosphoremia and a high parathormone level (287 pg/ml). Imaging showed spread myeloma impairment and a right paramediastinal tissular mass. Biopsy diagnosed an ectopic parathyroidal adenoma.DiscussionMultiple myeloma and primary hyperparathyroidism can be associated. They are often revealed by an hypercalcemia difficult to control or refractory to the treatment. Hypophosphoremia can suggest the diagnosis of hyperparathyroidism. Both this observation and litterature (about twenty case reports) suggest that this double diagnosis should be systematicly evoked and explored by an assay of parathormone and a seric proteins electrophoresis in all hypercalcemia.ConclusionMultiple myeloma and parathyroidal adenoma should be both explored in all hypercalcemia, because they can be associated.

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