Vertebra Localized Solitary Plasmacytoma May Be The Cause Of Acute Paraplegia

Year 2017, Volume: 9 Issue: 1, 1 - 3, 01.04.2017

Selin Cilli Hayal Ahmetoğlu Nurdan Kotevoğlu

Abstract

Plasma cell neoplasms are classified as plasma cell myelomas, plasmacytomas, immunglobulin deposit diseases, POEMS syndrome osteoclastic myeloma and light chain diseases. Solitary plasmacytoma is a local primary bone tumor composed of malignant plasma cells, forming 10% of the plasma cell neoplasms. Our case was important because of rarity of vertebral localized plasmacytoma causing acute paraplegia. An 80-year-old male patient was admitted to the emergency room with sudden onset weakness in the lower extremities. The patient, who had no trauma, had no complaints on his follow-up with the diagnosis of costal solitary plasmacytoma 20 years ago. He did not have comorbidities either. Patient was conscious, oriented and cooperated. Diagnose was T6 vertebra leveled ASIA-A spinal cord injury. Aortic dissection was not considered at the diagnosis. Cranial CT was usual. In cervical, thoracic and lumbar MRI images, an intradural extramedullary isointense mass was found that posteriorly compresses spinal cord at the T6 vertebral region in the T2 sequence. The mass was removed. Pathologic result of the mass was reported as plasmacytoid diffuse tumor proliferation. In PET-CT: foci of multiple localization, intense, increased FDG involvement without computerized tomography correspondence were detected. In cases with back pain and weakness in lower exremities tumoral stuctures even diagnosed long ago and accepted as recovery should be considered.

Keywords

Paraplegia, plasmacytoma, spinal cord injury

Vertebra Lokalizasyonlu Soliter Plazmasitom Akut Parapleji Nedeni Olabilir

Abstract

Plazma hücre neoplazileri plazma hücre miyelomu, plazmasitom, immunglobulin depo hastalıkları, POEMS sendorumu osteoklastik myelom ve hafif zincir hastalıkları olmak üzere sınıflandırılır. Soliter plazmasitom plazma hücre neoplazilerinin % 10 unu oluşturan, malign plazma hücrelerinden oluşan lokal primer kemik tümörüdür. Olgumuz nadir görülen vertebra lokalizasyonlu plazmasitomun akut paraplejiye yol açması açısından önem arz ediyordu. 80 yaşında erkek hasta acil servise alt ekstremitelerde ani başlayan güçsüzlük ile başvurdu. Travma tanımlamayan hastanın 20 yıl önce kostal soliter plazmasitom tanısı olmakla birlikte takiplerinde şikayeti yoktu. Komorbiditesi de bulunmuyordu. Bilinç açık, oryante, koopereydi. T6 vertebra seviyeli ASİA A spinalkord hasarı tespit edildi. Ön tanıda aort diseksiyonu düşünülmedi. Kranyal BT normal olarak bulundu. Servikal, torasik ve lomber MR görüntülemelerde T2 sekansında T6 vertebra bölgesinde spinal korda posteriordan bası yapan intradural ekstramedüller izointens kitle saptandı. Kitle eksize edildi. Patoloji sonucu plazmasitoid diffüz tümöral proliferasyon olarak rapor edildi. Çekilen PETBT de multipl lokalizasyonlu, BT karşılıkları izlenmeyen, normalden yoğun artmış FDG tutulum odakları saptandı. Sırt ağrısı, ekstremitelerde güçsüzlük durumunda etyolojide çok uzun yıllara uzanan ve şifa bildirilen tümoral nedenler de göz önünde bulundurulmalıdır.

Keywords

Parapleji, plazmasitom, spinalkord hasarı

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