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

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...

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Bibliographic Details
Published in:Journal of medical case reports 2020-10, Vol.14 (1), p.189-189, Article 189
Main Authors: Di, Long, Huang, Kevin, Kesayan, Tigran, Kroll, Derek, Baz, Rachid C, Macaulay, Robert J, Tran, Nam D
Format: Article
Language:English
Subjects:
African Americans
Aged
Anemia
Antineoplastic agents
Back pain
Biopsy
Bone marrow
Cancer
Cancer metastasis
Case Report
Case reports
Daratumumab
Development and progression
Gene expression
Humans
Intramedullary spinal cord neoplasm
Literature reviews
Magnetic Resonance Imaging
Male
Medical prognosis
Metastasis
Multiple myeloma
Multiple Myeloma - diagnosis
Multiple Myeloma - diagnostic imaging
Mutation
Patients
Physiology
Plasma
Spinal cancer
Spinal Cord
Spinal Cord Neoplasms - diagnostic imaging
Spinal Cord Neoplasms - surgery
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Summary: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. 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. 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.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-020-02496-5