Abstract
Multiple myeloma is the second most common hematologic malignancy. It is characterized by the neoplastic proliferation of plasma cells in the bone marrow, leading to excessive production of monoclonal immunoglobulin. The mean age at diagnosis is 65 years. There are only a few cases of Multiple Myeloma arising in young population reported in the literature. We present a case of 33-years-old male presented with complete bilateral lower limbs paralysis and loss of sensation which were gradual in onset and accompanied by upper and lower back pain for 1 month. MRI of the whole spine show multiple infiltrative bone marrow high signal in T2 and STIR sequences involve C4 and the upper dorsal vertebral bodies and the spinous process of D4 with left para-spinal and large posterior epidural mass compress the spinal cord. CT guidance obtains three samples from the mass and placed in formalin in separate containers. Histopathology examination revealed neoplastic growth composed of Sheet of diffuse atypical plasma cells infiltrating fibro collagenous and adipose tissue. Although Multiple myeloma is a disease of elderly; it still could present in young age group. Histopathology examination is the gold standard for diagnosis.
Highlights
Multiple myeloma is a condition characterized by the neoplastic proliferation of plasma cells in the bone marrow, leading to the excessive production of monoclonal immunoglobulin.[1]
We present a case of 33-year-old male with Multiple myeloma presented initially with complete lower limb paralysis with loss 3 of 6 birpublications.org/bjrcr
Case Report: Multiple myeloma of young adult presented with paraplegia of sensation bilaterally
Summary
Multiple myeloma is a condition characterized by the neoplastic proliferation of plasma cells in the bone marrow, leading to the excessive production of monoclonal immunoglobulin.[1]. CT chest with contrast (Figure 2a) soft tissue window show left paraspinal mass extend to the posterior epidural space through the left T2-T3 neural foramen, 2b, 2c and 2d bone window vertebral bodies punched out well defined multiple lytic lesions with endosteal scalloping. CT scan for lumbar spine was done and shows multiple lytic lesions involving the lumbar vertebral bodies, sacrum and left iliac bones. MRI of the whole spine show multiple infiltrative bone marrow high signal in T2 and STIR sequences involve C4 and the upper dorsal vertebral bodies and the spinous process of D4 with left paraspinal and large posterior epidural mass compress the spinal cord, The left paraspinal mass show lobulated outline likely coming from the D4 vertebral body and pedicle measures 6.1 × 2.7×5.2 cm Figure 2. The patient was diagnosed with renal failure; he was referred to tertiary center due to the lack of resources needed for further appropriate management
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