title: Multiple myeloma and paget disease with abnormal skull lesions and intracranial hypertension.
abstract: We report a 73 years old man with a diagnosis of Paget Disease (PD) and symptomatic Multiple Myeloma (MM). Coexistence of MM and PD has rarely been described. PD mimics many of the features of bone destructive process in MM, making differential diagnosis more complicated. In addition, the presence of serious muscolo-skeletal and metabolic complications in both diseases makes management of patients difficult, worsening the prognosis.The comparison of these two diseases has led to the characterization of a common molecular mechanism represented by the receptor activator of nuclear factor-kB ligand (RANKL)/Osteoprotegerin signaling pathway. The improved comprehension of these mechanisms led to the development of new pharmacologic agents (bisphosphonates, cytokines inhibitors) effective for the treatment of these bone diseases.
authors.affiliation: Hematology Department, S. Eugenio Hospital - Rome - Italy.
authors.forename: T
authors.initials: T
authors.lastname: Caravita
authors.forename: A
authors.initials: A
authors.lastname: Siniscalchi
authors.forename: E
authors.initials: E
authors.lastname: Montinaro
authors.forename: R
authors.initials: R
authors.lastname: Bove
authors.forename: M
authors.initials: M
authors.lastname: Zaccagnini
authors.forename: D
authors.initials: D
authors.lastname: De Pascalis
authors.forename: A
authors.initials: A
authors.lastname: Morocutti
authors.forename: L
authors.initials: L
authors.lastname: Brusa
authors.forename: F
authors.initials: F
authors.lastname: Arciprete
authors.forename: Ml
authors.initials: M
authors.lastname: Cupini
authors.forename: A
authors.initials: A
authors.lastname: Perrotti
authors.forename: E
authors.initials: E
authors.lastname: Palma
authors.forename: S
authors.initials: S
authors.lastname: Fratoni
authors.forename: R
authors.initials: R
authors.lastname: De Simone
authors.forename: C
authors.initials: C
authors.lastname: Iani
authors.forename: P
authors.initials: P
authors.lastname: de Fabritiis