Multiple myeloma bone lesions in skeletal remains : report of two known cases from the 20th century CAL Milano Cemetery Skeletal Collection

Multiple myeloma (MM) is of special interest in anthropology, in particular in the differential diagnosis with metastatic carcinoma. In this paper, we present two cases of known MM and discuss the criteria for diagnosis in comparison with the literature. Two skeletons from the identified CAL Milano Cemetery Skeletal Collection were selected for the antemortem clinical diagnosis of MM in their associated medical data. Each lesion observed during the anthropological analysis was reported and considered. Lesions were observed in both cases in the pelvis, sacrum, ribs, vertebrae, scapulae, proximal ends of femora and humeri as well as in the skull. Moreover, they presented similar morphological traits. Consequently, lesions in MM are multifocal, round, lytic, sharply demarcated, relatively uniformly small, and specifically located in highly vascularized areas of the skeleton. These results are consistent with data from the literature and strengthen the criteria for diagnosis of the condition.