Multiple myeloma

Case contributed by Konstantin Benno Bräutigam

Presentation

Severe low back pain without known trauma. No fever but intense night sweats. No known malignoma. Neurologically no deficits, power, sensibility and motor function completely intact. Normochromic normocytic anemia.

Patient Data

Age: 75 years
Gender: Male
X-ray

X-ray of the lumbar spine detected scoliosis and a Baastruup phenomenon but no fracture.

MRI

Unstable pathological fracture of T11 due to an unknown paravertebral soft tissue tumour. Spinal canal is constrained more than fifty percent.

Case Discussion

The patient's history in combination with the MRI raised suspicion for multiple myeloma. First of all, the thoracic spine was decompressed and dorsally stabilised. An intraoperative biopsy showed an immature plasma cell neoplasia. Bone marrow biopsy then confirmed multiple myeloma, IgA-lambda-type, and radiochemotherapy was initiated.

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Case information

rID: 57041
Published: 6th Dec 2017
Last edited: 12th Feb 2018
Inclusion in quiz mode: Included
Institution: Charité Universitätsmedizin Berlin

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