Science and Education Publishing American Journal of Medical Case Reports 2374-216X 3 8 2015 07 02 Pulmonary Embolism: A Rare Initial Manifestation of Multiple Myeloma 244 246 EN Parijat Sen Abhishek Kumar Mary Mathews Department of Internal Medicine, St. Joseph's Regional Medical Center, New Jersey, USA Daphne Macbruce Richard Miller AJMCR2015386 10.12691/ajmcr-3-8-6 2015 06 15 2015 06 28 2015 07 02 Multiple Myeloma usually presents with end organ damage like bone symptoms such as pain, pathologic fracture, renal dysfunction, chronic fatigue from anemia or symptoms of hypercalcemia. Although frequently associated with venous thromboembolisms, the presentation of multiple myeloma with pulmonary embolism as its initial manifestation is extremely rare. We report the case of a 60 y/o Hispanic male who presented with a Pulmonary Embolism, further diagnostic test revealed an underlying diagnosis of Multiple Myeloma.