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Clinical Problem Solving
June 2014

External Nasal Lesion in a Middle-aged Man

Author Affiliations
  • 1New York University School of Medicine, New York

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Otolaryngol Head Neck Surg. 2014;140(6):569-570. doi:10.1001/jamaoto.2014.346

A man in his 60s who was from the Caribbean Islands and had a history of multiple myeloma presented with a right external nasal lesion. The diagnosis of multiple myeloma had been made several years previously in the setting of a thoracic spine compression fracture, for which he was initially treated with radiation along with a stem cell transplant. He was now stable, receiving therapy with revlimid and prednisone. During routine surveillance using positron electron tomographic–computed tomographic imaging for the multiple myeloma, a 1.8-cm fluorodeoxyglucose F18–avid speculated density was noted in the lower lobe of the right lung. This was believed to be inflammatory and/or infectious in nature, and a course of moxifloxacin was given.