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A 46-year-old woman presented and IgG myeloma without metastases at the time of the diagnosis. A complete hematologic remission was achieved with melphalan and prednisone, but the patient then developed a polysymptomatic condition with myelomatous metastases in different organs. In some cases these were confirmed histologically (meninges, stomach, skin, and scalp); in others there was a strong clinical evidence (liver, oral mucosa, lymph nodes, and lumbar vertebra). There were manifestations of the disease in all of these sites, while complete hematologic remission was maintained. The meningeal metastasis was treated by surgery and irradiation with orbital penetration; the lymph nodes were irradiated, and COPP polychemotherapy was given to treat the rest of the metastatic localizations. In this way an apparently remission was achieved temporarily. The incidence of each one of the extraskeletal manifestations in this unusual case of myeloma is reviewed in the literature.
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