eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2025-06-30 18 2 1759 1764 10.13005/bpj/3212 65961 article Anton Sumarpo 1 Catherine Keiko Gunawan 2 Vegy Supriadi 1 Erica Valencia Imannuel 1 Budiono Raharjo 3 Stephani Linggawan 4 Department of Clinical Pathology, Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia Medical Profession Study Program, Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia Department of Clinical Pathology, Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, Surabaya, Indonesia Department of Ear, Nose, and Throat, Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, Surabaya, Indonesia Department of Clinical Pathology, Lambung Mangkurat University, Banjarmasin, Indonesia Multiple myeloma (MM) is a hematological malignancy characterized by the clonal proliferation of plasma cells and the excessive accumulation of monoclonal protein. While primary manifestations such as bone pain, renal dysfunction, anemia are well-documented features, extra-hematological complications, including achalasia, are exceedingly rare. We present a 76-year-old male with 10-month history of persistent dysphagia. Laboratory test revealed anemia, leukocytosis, and neutrophilia, while serum protein electrophoresis indicated dysproteinemia. Bone marrow aspiration confirmed MM with 25% plasma cell infiltration. Imaging and endoscopic findings further identified a lytic cervical spine lesion and esophageal motility dysfunction consistent with achalasia. This case presents a rare presentation extra-hematological presentation of MM, emphasizing the need for a comprehensive diagnostic approach to facilitate timely recognition and appropriate management of MM. https://biomedpharmajournal.org/vol18no2/achalasia-a-rare-manifestation-of-multiple-myeloma-a-case-report/ Achalasia Clonal proliferation Dysphagia Extra-hematological presentation Multiple myeloma