• Qianshuang Geng, Jie Li, Xi Li, Wenjie Zhang, Guoxiang Zhang, Li Ge, and Li Liang.
• Department of Hematology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China.
• Medicine (Baltimore). 2024 Feb 2; 103 (5): e36951e36951.

RationaleNonsecretory multiple myeloma (NSMM) is a rare subtype of multiple myelom, occurring in 1% to 2% of multiple myelom and characterized by the inability of clonal plasma cells to synthesize or secrete immunoglobulins. We describe a 71-year-old male patient who began with bone pain and was referred to hospital several times, but was not properly diagnosed and effectively treated.Patient ConcernsA 71-year-old male patient visited our hematology department, complaining of lumbago for 1 year and back pain for half a year.DiagnosesLow-dose whole-body bone computed tomography: multiple bone destruction of the sternum, ribs, multiple vertebrae and accessories of the spine, pelvis, bilateral humerus, and proximal femur. Monoclonal plasma cells accounted for 17.5% of nuclear cells in bone marrow puncture smear. Fluorescence in situ hybridization detected amplification of CKS1B (1q21) gene. Immunofixation electrophoresis negative. About 10.72% of monoclonal plasma cells were detected by flow cytometry. Finally, he was diagnosed with NSMM.InterventionsThe patients received VCD chemotherapy (bortezomib 1.3 mg/m2, d1, d4, d8, d11; cyclophosphamide 300 mg/m2, d1-2, d8-9; dexamethasone sodium phosphate 20 mg, d1-2, d4-5, d8-9, d11-12, once every 21 days).OutcomesAfter 2 cycles of VCD treatment, the symptoms of bone pain were significantly relieved, and the efficacy was evaluated as partial response. Follow-up chemotherapy will continue to be completed on schedule. We will continue to follow up to further evaluate the overall survival and progression-free survival.LessonsThis case shows that NSMM is easily missed or misdiagnosed.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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