Case Presentation A 61-year-old postmenopausal woman with a history of hypertension and diabetes presented with a four-month history of progressively worsening lower back pain. She denied any history of trauma, fever, weight loss, night sweats, limb weakness, or urinary symptoms.
She also reported noticing a gradually enlarging neck mass for several months before the onset of back pain. Physical Examination Alert, oriented, and well-appearing Blood pressure: 134/101 mmHg; heart rate: 86 bpm; temperature: 37.0°C; respiratory rate: 16; SpO₂: 97% Normal strength and sensation in lower limbs No spinal tenderness on palpation Laboratory Findings Routine Labs: Hemoglobin: 13.5 g/dL WBC: 6.2 × 10⁹/L Platelets: 240 × 10⁹/L Serum calcium: 9.4 mg/dL Creatinine: 0.9 mg/dL TSH: 1.6 µIU/mL Free T4: 1.2 ng/dL Free T3: 3.1 pg/mL Total protein and albumin: Normal Workup for multiple myeloma: Negative…
