Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2555
Peer-review started: November 17, 2020
First decision: January 7, 2021
Revised: January 19, 2021
Accepted: February 10, 2021
Article in press: February 10, 2021
Published online: April 16, 2021
Processing time: 124 Days and 10.6 Hours
Multiple myeloma is a malignant hematological disease characterized by proliferation of monoclonal plasma cells mainly in the bone marrow. Extraosseous epidural plasmacytoma associated with myeloma arises from lymphoid tissue in the epidural space without focal vertebral involvement, and is rare.
A 52-year-old woman was diagnosed with kappa subtype nonsecretory multiple myeloma and presented with bilateral arm weakness 11 mo after completing multiple courses of chemotherapy. Spinal magnetic resonance imaging (MRI) showed a posterior C7–T3 epidural mass with spinal cord compression. After five courses of chemotherapy, follow-up MRI showed resolution of cord compression. A 54-year-old man presented with paraplegia 15 mo after a diagnosis of IgD kappa subtype multiple myeloma and completing multiple courses of chemotherapy. He underwent Th11 and L1 laminectomies for tumor resection because MRI showed an epidural mass causing cord compression. His-topathologic examination was consistent with IgD multiple myeloma. The patients have currently survived for 33 mo and 19 mo, respectively.
Isolated extraosseous epidural plasmacytoma associated with multiple myeloma without bony involvement is difficult to diagnose by imaging. Definitive diagnosis requires pathological and immunohistochemical examination.
Core Tip: Extraosseous epidural plasmacytoma associated with multiple myeloma is believed to arise from lymphoid tissue in the epidural space. Patients with these lesions can present with normal or diffuse vertebral bone marrow patterns on magnetic resonance imaging. Chemotherapy and laminectomy should be considered for treatment.