Contribution of Surgery in Solitary Plasmacytoma of Spine; A Case Report

Document Type : CASE REPORT

Authors

1 Orthopaedic Surgery Department, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Neurosurgery Department, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Solitary plasmacytoma of bone is a rare malignant tumor mostly involving the axial skeleton. The tumor occurs in middle- aged or elderly people (mean age: 55 years) and has a high risk of progression to multiple myeloma. Radiotherapy is the preferred treatment for this disease. We report a case of recurrent solitary plasmacytoma of the fourth lumbar vertebra in a 35-year-old male. The patient suffered from intractable pain due to a pathologic fracture and instability. We performed two-stage posterior and anterior surgical procedures on him. Our method was useful for immediate pain relief and early return to activity, spinal decompression and biomechanical stabilization of the involved vertebra. Afterward, the patient underwent radiotherapy as the adjuvant therapy. The patient is asymptomatic without any recurrenceafter a one-year follow up. We recommend surgery as an appropriate option for patients with intractable pain as a result of pathologic fracture, vertebral instability, neurological compromise, failure of radiotherapy or a combination of these disorders.

Keywords

References

  1. Dumesnil C, Schneider P, Dolgopolov I, Radi S, Leluyer B, Vannier JP. Solitary bone plasmocytoma of the spine in an adolescent. Pediatr Blood Cancer. 2006; 47: 335-8.

  2. Tsutsumi S, Yasumoto Y, Ito M. Solitary spinal extradural plasmacytoma: a case report and literature review. Clin Neuroradiol. 2013; 23:5-9.

  3. Soutar R, Lucraft H, Jackson G. Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma. Clin Oncol. 2004;16:405-13.

  4. Weber DM. Solitary Bone and Extramedullary Plasmacytoma. Hematology Am Soc Hematol Educ Program. 2005:373-6.

  5. Yang JS, Cho YJ, Kang SH, Choi HJ. Rapid progression of solitary plasmacytoma to multiple myeloma in lumbar vertebra. J Korean Neurosurg Soc. 2013; 54:426-30.

  6. Bolek TW, Marcus RB, Mendenhall NP. Solitary plasmacytoma of bone and soft tissue. Int J Radiat Oncol Biol Phys. 1996;36:329-33.

  7. Liebross RH, Ha CS, Cox JD, Weber D, Delasalle K, Alexanian R. Solitary bone plasmacytoma: outcome and prognostic factors following radiotherapy. Int J Radiat Oncol Biol Phys. 1998; 41:1063-7.

  8. Baba H, Maezawa Y, Furusawa N, Wada M, Kokubo Y, Imura S, et al. Solitary plasmacytoma of the spine associated with neurological complications. Spinal Cord. 1998; 36: 470-5.

  9. Huang W, Cao D, Ma J, Yang X, Xiao J, Zheng W,et al. Solitary plasmacytoma of cervical spine: treatment and prognosis in patients with neurological lesions and spinal instability. Spine (Phila Pa 1976). 2010; 35: 278-84.

  10. Terada T. Solitary plasmacytoma of the thoracic vertebra presenting with sudden paraplegia and back pain: a pathologic case report. Pathol Oncol Res. 2011; 17:167-9.

  11. Sinha PK, Paul R, Bandyopadhyay R, Roy A. Solitary plasmacytoma of the axis vertebra presenting as severe neck pain. J Assoc Physicians India. 2011; 59:334-5.

  12. Yamazaki T, McLoughlin GS, Patel S, Rhines LD, Fourney DR. Feasibility and safety of en bloc resection for primary spine tumors: a systematic review by the Spine Oncology Study Group. Spine (Phila Pa 1976). 2009;34:31-8.

  13. Kawahara N, Tomita K, Murakami H, Demura S. Total en bloc spondylectomy for spinal tumors: surgical techniques and related basic background. Orthop Clin North Am. 2009;40:47-63.

  14. Von der Hoeh NH, Tschoeke SK, Gulow J, Voelker A, Siebolts U, Heyde CE. Total spondylectomy for solitary bone plasmacytoma of the lumbar spine in a young woman: a case report and review of literature. Eur Spine J. 2014; 23:35-9.

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History

  • Receive Date: 19 February 2014
  • Revise Date: 01 April 2014
  • Accept Date: 03 May 2014

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