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March 1980

Pathologic Flail Chest Complicating Multiple Myeloma

Author Affiliations

From the Cardiovascular-Pulmonary Division (Drs Fleegler, Fogarty, and Owens) and the Hematology-Oncology Section (Dr Cassileth) and the Department of Medicine (Dr Cohen), Hospital of the University of Pennsylvania, Philadelphia.

Arch Intern Med. 1980;140(3):414-415. doi:10.1001/archinte.1980.00330150128031

• Pathologic flail chest complicated the initial presentation of multiple myeloma in two patients. Both had severe hypercalcemia and diffuse bone disease. Atelectasis and pulmonary edema preceded the appearance of flail chest in one patient; atelectasis complicated the flail chest in the second patient and increased the severity of the flail. Both were treated with radiotherapy and chemotherapy. However, delay in stabilizing the first patient's chest wall with positive airway pressure was followed by extension of the flail chest and irreversible respiratory failure. On the other hand, prolonged stabilization of the chest wall in the second patient until a chemotherapy-induced remission occurred was associated with resolution of the flail chest.

(Arch Intern Med 140:414-415, 1980)