Multiple myeloma with otologic manifestation: case report

Abstract

Introduction: Multiple myeloma is a neoplasm that results in the disordered multiplication of plasma cells, production of monoclonal immunoglobulin and normally presents as osteolytic lesions. Otologic changes associated with multiple myeloma are rare and can be confused with several chronic ear manifestations. Objective: To describe the case of a patient with involvement of the temporal bone by multiple myeloma presenting otologic manifestations. Method: Case report collected through clinical interviews and patient’s consent after signature of the informed consent form. Results: Male patient, 74 years old, with signs of hypoacusis, physical examination without significant changes, and asymmetric audiometry with mixed hearing loss in the left ear and sensorineural hearing loss in the right ear. The diagnosis was suspected by computed tomography that showed hypoattenuating content filling the cells of the left mastoid, with sclerosis of the internal cortical bone suggesting malignant neoplasm or calcium absorption disorder. He was referred to a hematologist, who confirmed multiple myeloma and started treatment. Considerations for the practice of general practitioners: Awareness that certain otologic manifestations may be indicative of systemic conditions, such as multiple myeloma, highlights the relevance of the general practitioner in early detection and appropriate referral to a multidisciplinary approach.