Cui JF, Sun LL, Liu H, Gao CP. Extraosseous spinal epidural plasmocytoma associated with multiple myeloma: Two case reports. World J Clin Cases 2021; 9(11): 2555-2561 [PMID: 33889620 DOI: 10.12998/wjcc.v9.i11.2555]
Corresponding Author of This Article
Chuan-Ping Gao, MD, Professor, Department of Radiology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China. gaochuanping@yahoo.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jiu-Fa Cui, Chuan-Ping Gao, Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Ling-Ling Sun, Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Hua Liu, Department of Radiology, Shinan People Hospital of Qingdao, Qingdao 266003, Shandong, China
Author contributions: Cui JF and Liu H reviewed the literature and drafted the manuscript; Sun LL was the pathologist involved in the case, reviewed the literature, and drafted the manuscript; Gao CP proofread the manuscript; All authors issued final approval of the version for submission.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chuan-Ping Gao, MD, Professor, Department of Radiology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China. gaochuanping@yahoo.com
Received: November 17, 2020 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
