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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2020

Open Access 01-12-2020 | Multiple Myeloma | Case report

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

Authors: Long Di, Kevin Huang, Tigran Kesayan, Derek Kroll, Rachid C. Baz, Robert J. Macaulay, Nam D. Tran

Published in: Journal of Medical Case Reports | Issue 1/2020

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Abstract

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.
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Metadata
Title
Multiple myeloma presenting as an intramedullary spinal cord tumor: a case report and review of the literature
Authors
Long Di
Kevin Huang
Tigran Kesayan
Derek Kroll
Rachid C. Baz
Robert J. Macaulay
Nam D. Tran
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2020
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-020-02496-5

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