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2026, Number 1

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Cir Columna 2026; 4 (1)

Multimodal management of a thoracic epidural plasmacytoma associated with multiple myeloma. Case report and literature review

Flores MMA, Arroyo ZOJ, Vázquez NJR

Language: Spanish
References: 20
Page: 58-63
PDF size: 861.46 Kb.


ABSTRACT

Introduction: extraosseous epidural plasmacytoma associated with multiple myeloma arises from lymphoid tissue in the epidural space, and this location is rare. The five-year survival rate is still just under 50%. Case presentation: a 52-year-old male presents with oppressive pain in the dorsal region accompanied by decreased strength of the lower extremities 1/5 and hypoesthesia below T4. Condition with a month of evolution. Magnetic resonance imaging showed a heterogeneous lesion in the epidural space at T2 that caused spinal cord compression. A T4-T5 hemilaminectomy was performed plus tumor excision, and was reported as a plasmacytoma; adjuvant management with radiotherapy was decided. Results: after surgery, the patient presented improvement in pelvic limb strength 4/5 and sensitivity. In MRI control one-year post-treatment, there is no evidence of tumor recurrence. Conclusions: epidural plasmacytoma associated with multiple myeloma represents a rare clinical entity, but of great relevance due to its potential to generate acute neurological deterioration. This case highlights the importance of timely evaluation by advanced imaging, histological confirmation, and multimodal therapeutic approach. Surgical intervention, followed by radiation therapy, allowed for significant functional recovery and sustained local control of the disease. Early identification and comprehensive treatment are decisive in optimizing the prognosis in patients with this condition.


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