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