A case of solitary myeloma of the sternum was treated with primary surgical resection. A 68-year-old man was admitted to the hospital because of an anterior upper chest wall tumor. CT scan showed a soft tissue density mass of the manubrium sterni extending into the bilateral calvicles and the first ribs with destruction of bone structure. Bone scintigram, 67Garium scintigram, and rentgenogram of other bones did not revealed any other lesions. Serum and urine protein electrophoresis revealed a immunoglobulin A of κ-chain monoclonal gammopathy but not Bence-Jones' albumose uria. A percutaneous needle biopsy of the tumor was done, and plasmacytoma was identified. Illiac and sternal gladiolus bone marrow aspirate revealed no evidence of myeloma. Therefore the patient was diagnosed as a solitary myeloma of the sternum and surgical resection was performed. En bloc resection of the muscle, manubrium, upper gladiolus, medial bilateral clavicles, and medial bilateral first and second ribs was carried out. The anterior chest wall defect was reconstructed with Marlex mesh and pectoralis major pedicles. Tumor size was 10.5×5.8×4.2cm. Seven months after the operation, serum monoclonal gammopathy disappeared and the patient is alive with no evidence of local or distant recurrence of myeloma. The correlation between the disease and multiple myeloma is still obscure and the disease arising the sternum is very rare. The en bloc resection of the tumor may be recommended as a primary treatment for patients with solitary myeloma involving the chest wall.