Extraosseous spinal epidural plasmocytoma associated with multiple myeloma: Two case reports

Table 1 Reported cases of extraosseous epidural myeloma

No.	Age in yr	Sex	subtype	Symptom and sign	Treatment	Neurological improvement/survival	Ref.
1	52	M	IgD/λ	Back and leg pain with paresthesia of legs1; Back pain with paraparesis2	Chemotherapy; Laminectomy	Improved with complete remission; Died of respiratory dysfunction/19 mo	Matsui et al[7], 1992
2	40	F	IgA/λ	Back pain with paraparesis; Progressive paraplegia	Plasmapheresis; Radiotherapy, chemotherapy	No improvement/7 mo	Palmbach et al[3], 1996
3	85	M	IgD/λ	Paraplegia, anesthesia below T6	Chemotherapy	No improvement/> 12 mo	Watanabe et al[11], 2000
4	45	F	IgG/λ	Low back pain, right L5, S1; Radioculopathy	Surgical resection; Chemotherapy	No improvement/> 5 mo	Hu et al[12], 2001
5	47	M	IgG/λ	Back pain, paraplegia sensory disturbance below T8	Chemotherapy; Radiotherapy	No improvement/> 6 mo	Okacha et al[6], 2008
6	60	F	IgG/λ	Paraplegia, sensory disturbance below T8	Laminectomy, local radiotherapy, chemotherapy	Improved/> 6 mo	Avadhani et al[13], 2010
7	53	F	NSM/k	Numbness of bilateral lower extremities	Chemotherapy	Improved/> 42 mo3	Present case
8	53	M	IgD/λ	Paraplegia	Chemotherapy, laminectomy	Improved/> 19 mo3	Present case

¹Lesion location: L3.

²Lesion recurrence: C7-T4.

³Patient still alive. NSM: Non-secretory myeloma.

Table 2 Imaging characteristics of extraosseous epidural myeloma

No.	Location	IF and paravertebral extension	T1WI	T2WI	Enhancement	Vertebrae infiltration
1	L3 posterior C7-T4 posterior1	No	N/A	Hyperintense	/	L2-L3
		Yes	N/A	Hyperintense	/	N/A
2	C7-L2/3 posterior	Yes	Isointense	Hyperintense	/	Diffuse
3	C7-T2 posterior	No	Isointense	Isointense	No	No
4	L5-S1 N/A	N/A	N/A	N/A	N/A	No
5	T4-T6 posterior	Yes	Hypointense	Hyperintense	Moderate	No
6	T6-T7 posterior	No	N/A	N/A	Yes	No
7	C7-T3 posterior	No	Isointense	Isointense	Moderate	Diffuse
8	T12-L1 posterior	No	Isointense	Isointense	/	Diffuse

¹Lesion recurrence; IF: Intervertebral foramen; T1WI: T1-weighted imaging; T2WI: T2-weighted imaging.