A 72-year-old atypical-multiple-myeloma patient, who visited the hospital for long-term persistent back pain and multiple fractures was reported. The patient had undergone treatment in several hospitals for back pain, with about 17 months of disease course. Several CT, MRI, and laboratory tests had been performed. The results showed that there was multiple bone destruction, and severe osteoporosis was considered. Lumbar 2nd/4th vertebral-body-fracture balloon kyphoplasty and lumbar 2nd vertebral-body biopsy were performed to treat the patient′s lumbar vertebral compression fractures. No tumor cells were found by the pathology examination. The patient was hospitalized in the Second Medical Center of Chinese PLA General Hospital for the persistently-aggravated back pain. According to the comprehensive evaluation, the patient had severe emaciation (cachexia state), anorexia, bedridden state, multiple pain, inability to stand and walk, anemia, hypercalcemia, multiple bone destruction, and no M-proteinemia. The results were considered as multiple myeloma, tumor′s bone metastasis (such as lung cancer, prostate cancer, carcinoid, etc.), histiocytosis X and severe osteoporosis. However, no tumor cells (including notable diagnostically-significant abnormal-plasma-cell proliferation) were found in both the trans-iliac puncture & biopsy and PET/CT-based rib-damaged-site CT-guided puncture & biopsy. Finally, multiple myeloma was definitely diagnosed by trans-sternal puncture. The patient then received the 6-consecutive-course of bortezomib combined with dexamethasone (PD or BD regimen) and 2-course of bortezomib and dexamethasone combined with doxorubicin liposome (PAD regimen). Furthermore, a therapeutic evaluation was performed every two courses. It showed the disease had got partially remitted (VGPR). Currently, the patient recovers to the self-care state before the illness.