A 70-year-old patient presents with back and trunk pain after cardiovascular disease has been ruled out. Which diagnosis is most likely?

A 70-year-old patient presents with back and trunk pain after cardiovascular disease has been ruled out. Which diagnosis is most likely?

• A. Lymphoma
• B. Leukemia
• C. Multiple myeloma
• D. Prostate cancer

Answer: (C)

When an older patient has persistent back and trunk pain and cardiac causes have been ruled out, think about malignant bone disease rather than heart issues. Multiple myeloma is a plasma cell cancer that often presents with bone pain, especially in the spine, due to osteolytic lesions. The spine and pelvis are common sites, so vertebral or vertebral compression-related pain is a classic presenting symptom in someone around this age. While other cancers like lymphoma, leukemia, or prostate cancer can also cause bone pain, they typically come with additional clues—lymphadenopathy or cytopenias for lymphoma/leukemia, or urinary symptoms and known primary or sex-specific risk factors for prostate cancer. The isolated trunk/back pain in a 70-year-old without cardiovascular explanations aligns most with multiple myeloma, making it the best fit for this scenario.

When an older patient has persistent back and trunk pain and cardiac causes have been ruled out, think about malignant bone disease rather than heart issues. Multiple myeloma is a plasma cell cancer that often presents with bone pain, especially in the spine, due to osteolytic lesions. The spine and pelvis are common sites, so vertebral or vertebral compression-related pain is a classic presenting symptom in someone around this age. While other cancers like lymphoma, leukemia, or prostate cancer can also cause bone pain, they typically come with additional clues—lymphadenopathy or cytopenias for lymphoma/leukemia, or urinary symptoms and known primary or sex-specific risk factors for prostate cancer. The isolated trunk/back pain in a 70-year-old without cardiovascular explanations aligns most with multiple myeloma, making it the best fit for this scenario.