Multiple myeloma presenting as recurrent obstructive uropathy.

A 51-year-old patient who presented with a four-day history of abdominal pain was found to have unilateral ureteral obstruction and an intracalyceal radiolucent filling defect on radiological studies. Further investigation of this was refused by the patient but then years later a repeat intravenous pyelogram showed persistence of the initial intracalyceal filling defect and ureteral obstruction in the contralateral kidney along with multiple intracalyceal radiolucent filling defects. Subsequent investigation led to a diagnosis of kappa light chain myeloma. The diagnosis of multiple myeloma should be considered in patients presenting with unexplained radiolucent filling defects.