Achalasia: A Rare Manifestation of Multiple Myeloma - A Case Report

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Abstract
Multiple myeloma (MM) is a hematological malignancy characterized by the clonal proliferation of plasma cells and the excessive accumulation of monoclonal protein. While primary manifestations such as bone pain, renal dysfunction, anemia are well-documented features, extra-hematological complications, including achalasia, are exceedingly rare. We present a 76-year-old male with 10-month history of persistent dysphagia. Laboratory test revealed anemia, leukocytosis, and neutrophilia, while serum protein electrophoresis indicated dysproteinemia. Bone marrow aspiration confirmed MM with 25% plasma cell infiltration. Imaging and endoscopic findings further identified a lytic cervical spine lesion and esophageal motility dysfunction consistent with achalasia. This case presents a rare presentation extra-hematological presentation of MM, emphasizing the need for a comprehensive diagnostic approach to facilitate timely recognition and appropriate management of MM.

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