Solitary Plasmacytoma of the Thoracic Spine
Journal Title: Journal of Case Reports and Studies - Year 2018, Vol 6, Issue 5
Abstract
Background: Solitary bone plasmacytomas account for approximately 5% of plasma cell malignancies. These lesions are recognized as pre-malignant, if untreated, at least 50% will progress to multiple myeloma within 5 years of diagnosis. We present a case of a 54 year old male patient whom presented to our unit complaining of progressive axial backache complicated by acute onset paraplegia of 8 hours duration. Neurological examination revealed an incomplete L1 sensory level and no motor function of his lower limbs which had power 0/5 in all dermatomes (Frankel B). Results: The patient was immediately commenced on steroid therapy and an emergency surgical intervention was instituted whereby a trans-pleural approach was utilized to perform a T12 corpectomy and expandable cage reconstruction of the anterior and middle column of the T12 vertebrae. This was augmented by a lateral plate. The post-operative histology confirmed the lesion to be a plasmacytoma. Post-operatively significant improvement in the patient’s neurology occurred whereby he improved to a point where he had normal sensation and slightly less than normal power in his lower limbs (Frankel D). He was referred for adjuvant radiotherapy. At his three month out-patient review the patient was ambulant with assistance and at his two year out-patient review he was free from recurrence. Conclusion: We suggest that emergency surgical spinal cord decompression and reconstruction as a single stage procedure in the context of patients with solitary plasmacytomas with acute myelopathy can result in significant improvement. Expedience is the key to a successful outcome and in this case surgery was performed within 12 hours of onset of symptoms.
Authors and Affiliations
Kelly A
Keywords
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- EP ID EP584878
- DOI 10.15744/2348-9820.6.501
- Views 85
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