Multiple myeloma presenting as an intramedullary spinal cord tumor: a case report and review of the literature.

Autor: Di L; Department of Neurosurgery, University of South Florida, Tampa, FL, USA., Huang K; Department of Neurosurgery, University of South Florida, Tampa, FL, USA., Kesayan T; Department of Neuro-Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA.; Department of Neurology, University of South Florida, Tampa, FL, USA., Kroll D; Department of Neuro-Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA., Baz RC; Department of Hematology and Oncology, Moffit Cancer Center, Tampa, FL, USA., Macaulay RJ; Department of Pathology, Moffit Cancer Center, Tampa, FL, USA., Tran ND; Department of Neurosurgery, University of South Florida, Tampa, FL, USA. nam.tran@moffitt.org.; Department of Neuro-Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA. nam.tran@moffitt.org.
Jazyk: angličtina
Zdroj: Journal of medical case reports [J Med Case Rep] 2020 Oct 16; Vol. 14 (1), pp. 189. Date of Electronic Publication: 2020 Oct 16.
DOI: 10.1186/s13256-020-02496-5
Abstrakt: Background: Extramedullary disease in multiple myeloma often portends a worse diagnosis. In approximately 1% of cases, multiple myeloma may metastasize to the central nervous system as either leptomeningeal involvement or an intracranial, intraparenchymal lesion. Spinal cord metastases, however, are exceedingly rare. We present a case of spinal cord multiple myeloma as well as a literature review of reported cases.
Case Presentation: A 66-year-old African American man with multiple myeloma presented with acute midthoracic pain and lower extremity paresis and paresthesia. Magnetic resonance imaging of the spine revealed two contrast-enhancing intramedullary enhancing lesions in the T1-T2 and T6-T7 cord. Resection with biopsy yielded a diagnosis of metastatic multiple myeloma.
Conclusion: To date, only six cases of extramedullary disease to the spinal cord in patients with multiple myeloma have been reported, including our patient's case. In all cases, neurologic deficit was observed at presentation, and magnetic resonance imaging of the spine revealed an intramedullary, homogeneously enhancing lesion. Current evidence suggests worse prognosis in patients with extramedullary disease to the central nervous system, and treatment paradigms remain debatable.
Databáze: MEDLINE
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