Expression of the insulin-like growth factor 1 receptor (IGF1R) was described in the majority of patients with extramedullary disease manifestation and positive expression profiles were associated with the occurrence of the high-risk cytogenetic alterations t(4;14), t(14;16) and were linked to reduced overall survival suggesting a potential selection advantage of IGF1R positive clones in the course of MM progression (113). The gene discussed is IGF1R; the disease is Miyoshi myopathy.