Solitary involvement of multiple myeloma in the upper thoracic spine, and anterior approach to thoracic region without full sternotomy: A case report

Abstract

Multiple myeloma is cancer that starts in the plasma cells in bone marrow. Bone x- rays may show fractures or hollowed out areas of bone. The most common skeletal sites are pelvis, skull, spine, ribs and femoral and humeral shafts. The unique anatomy of thoracic spine creates challenging surgery approaches. Treatment choices of hematological malignancies of the spine are surgery, chemotherapy and radiotherapy. Unilateral L-shaped manubriotomy does not require full sternotomy for upper thoracic segment pathologies. We present a case of multiple myeloma patient in the upper thoracic area and the surgical management. We present an approach to anterior pathology of the upper thoracic spine that obviates the need for sternotomy.

Keywords

• Multiple myeloma,Unilateral L-shaped manubriotomy,Anterior approach,Cervicothoracic junction

Üst torasik omurgada multipl miyelomun soliter tutulumu ve sternotomi yapılmaksızın torasik bölgeye anterior yaklaşım: Olgu sunumu

Öz

Multipl miyelom kemik iliğindeki plasma hücrelerinden başlayan bir kanser türüdür. Kemik grafileri kemikteki kırıkları ve oyukları gösterebilir. En sık tutulan iskelet alanları pelvis, kafatası, kaburgalar ve femur- humerus kemikleridir. Torasik omurganin özellikli anatomisi, bu bölgenin cerrahi yaklaşımlarını oldukça zorlaştırır. Omurgadaki hematolojik hastalıkların tedavi seçenekleri arasında cerrahi, kemoterapi ve radyoterapi seçenekleri yeralmaktadır. Tek taraflı L- şekilli manubriyotomi sayesinde üst torasik bölge patolojilerine yaklaşımlarda tam sternotomi gerekmemektedir. Üst torasik omur multiple myeloma hastasının cerrahi yönetimini sunmayı amaçladık. Sunulan cerrahi yöntem üst torasik bölgeye yaklaşımda sternotomi ihtiyacını ortadan kaldırmaktadır.

Anahtar Kelimeler

• Multipl Miyelom,Tek taraflı L-şekilli manubriyotomi,Anterior yaklaşım,Servikotorasik bileşke

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