[Mildred]

PET scan shows no lesions, but smoldering diagnosis?

by Mildred on Sat Dec 27, 2014 10:44 am

My husband was recently diagnosed with smoldering myeloma after several months of testing. One of the first tests was a skeleton x ray which showed small lytic lesions between elbow and wrist. Eventually our oncologist ordered a PET scan, which came back cleared of lesions.

I recently had my wellness check up and was speaking with both my husband's and my internist . We have been having this internist for the last twenty years and are very blessed that he recognized the symptoms in my husband in the early stages. While we were discussing my husband, he made the comment that if it were not for the lytic lesions on the X-ray, my husband probably would have been diagnosed with MGUS.

My question here is: If the PET scan was negative, why smoldering?

Also, when asked how long could my husband smolder, his answer was forever.

[Dano]

Re: PET scan shows no lesions, but smoldering diagnosis?

by Dano on Sat Dec 27, 2014 11:48 am

During my initial diagnostic work up, my X-rays were clear and my doctor ordered a PET scan, which showed lytic lesions in my spine. It is my understanding that PET scan is more definitive than X-ray, especially during the early phase of the disease.

I agree with you that if your husband has lytic lesions, he is not smoldering. Diagnostically, if a patient displays any one of the four CRAB features, he has active disease. The finding of lytic lesions would be definitive for active (symptomatic) multiple myeloma, not smoldering myeloma and not MGUS.

I hope your husband is seeing a myeloma specialist and not just a general oncologist. Myeloma is rare and complicated and needs the management of a myeloma specialist.

Wishing you and your husband the best.

[Mildred]

Re: PET scan shows no lesions, but smoldering diagnosis?

by Mildred on Fri Jan 09, 2015 12:21 am

Hello, and sorry I haven't responded sooner, but I did not realize I had a response, plus, with the holidays, I was giving ourselves a break from my constant research.

I agree with you and believe the PET scan is a more accurate test then the skeletal x ray, which in our case would be good, since the PET scan showed nothing.

We are seeing a myeloma specialist and are very confident in his expertise.

May you stay happy and healthy in 2015!