Multiple myeloma

Case contributed by Konstantin Benno Bräutigam

Presentation

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

Patient Data

Age: 75 years
Gender: Male
X-ray

Scoliosis and a Baastrup phenomenon but no fracture.

MRI

Unstable pathological fracture of T11 due to an unknown paravertebral soft tissue tumor. 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 stabilized. 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: 13th Jun 2020
Inclusion in quiz mode: Included
Institution: Charité Universitätsmedizin Berlin

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