Multiple Myeloma with Peritoneal Metastases
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Multiple myeloma typically presents with lytic lesions in the axial skeleton, but may also present in the long bones. Extramedullary disease occurs less frequently, but may occur in the peritoneum, lungs, liver, or lymph nodes, to name a few locations. Radiographic bone survey is used to screen for lytic lesions, but is less sensitive than MRI in the spine. PET-CT can be used to establish a baseline distribution of disease, as well as to monitor response to treatment.A 50-year-old male with history of cirrhosis secondary to Hepatitis B and C and treated multiple myeloma presented to the emergency department with abdominal distension, confusion, and lethargy. Biochemical investigations were significant for azotemia, hyponatremia, thrombocytopenia, and anemia

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