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Malignancy is an independent risk factor of venous thromboembolism, although it is difficult to determine whether occult cancer is the cause of unprovoked VTE. About 25% of patients with VTE remain idiopathic. Here, the authors report the case of a 63-year-old woman with a history of unprovoked VTE some 10 months previously who presented with recurrent cough and dyspnea of 6 months’ duration and was finally diagnosed to have multiple myeloma.