A 51-year-old woman presents with fever, headache and generalised body pain. On examination, the patient is evidently distressed and describes the pain as equivalent to stabbing the bones over her head, chest and spine. Her investigations reveal haemoglobin 9gm/dl, platelet count 1lakh/cm 3 , elevated serum creatinine and blood urea. Her serum electrolytes and minerals are normal except for elevated calcium levels. Her serum proteins are elevated with reversal of A/G ratio.
X-ray skull was taken and is shown attached. What is the most probable diagnosis? What other investigations are required? Image source: neuroradiologycases.com
