Interesting ImagesImproved Detection of Minimal Residual Disease by 11C-Methionine PET/CT in a Young Patient With Unusual Extramedullary Presentation of Recurrent Multiple MyelomaCaldarella, Carmelo MD; Annunziata, Salvatore MD; Pagano, Livio MD; De Stefano, Valerio MD; Rufini, Vittoria MD Author Information From the Institutes of *Nuclear Medicine, and †Hematology, Università Cattolica del Sacro Cuore, Rome, Italy. Received for publication July 7, 2016; revision accepted October 4, 2016. Conflicts of interest and sources of funding: none declared. Correspondence to: Carmelo Caldarella, MD, Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy, Largo Agostino Gemelli, 8, 00168, Rome, Italy. E-mail: [email protected]. Clinical Nuclear Medicine 42(2):p e130-e134, February 2017. | DOI: 10.1097/RLU.0000000000001462 Buy Metrics Abstract Extramedullary relapse of multiple myeloma (MM) is uncommon. A 40-year-old woman with history of MM underwent PET/CT using 11C-methionine (C-MET) after the detection of a vulvar lesion on MRI, biopsy proven to be extramedullary relapse of MM. The vulvar lesion was negative at the 18F-FDG PET/CT but showed high uptake of C-MET; focal uptake of both 18F-FDG and C-MET was shown within the muscles of the left leg, histologically confirmed as extramedullary relapse of MM. 18F-FDG PET/CT performed after chemotherapy showed no uptake in both sites, whereas posttreatment C-MET PET/CT showed persistence of residual uptake within the vulvar lesion. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.