Unusual Extramedullary Manifestation in Multiple Myeloma Bilateral Synchronous Testicular Infiltration

A 73-year-old man with multiple myeloma (initial diagnosis 21 months earlier) was referred to our center for a whole-body F-18-FDG PET/CT. We detected a bilateral synchronous testicular manifestation, which was confirmed by histopathology after orchiectomy. Besides hypermetabolic lesions in the spine and ribs (most likely old fractures), known osteolysis showed no uptake. Extramedullary manifestation occurs in 13% to 20% of cases, among these 4% demonstrate testicular manifestation, which is associated with poor survival rates. Optimal therapy management is still unclear, due to limited data. To the authors' knowledge, so far only 3 comparable cases have been described.

Automated summary

A 73-year-old man with multiple myeloma was found to have bilateral synchronous testicular manifestation during his F-18-FDG PET/CT scan. This rare finding was confirmed by histopathology after orchiectomy. Only a small percentage of multiple myeloma cases show testicular manifestation, and the optimal therapy management for such cases is still unclear.