Abstract
IntroductionSpinal cord compression is a potentially devastating condition that demands immediate attention. Efforts must be divided between addressing the symptoms of cord compression and identifying the precise etiology of the condition.Case presentationA 76-year-old Peruvian man presented to our emergency department for evaluation of the gradual onset of lower extremity weakness over one month, resulting in falls and a two day history of bladder and bowel incontinence. Surprisingly, the etiology of this case of spinal cord compression was found to be multiple myeloma presenting as a solid tumor.ConclusionWe report a case of a spinal cord mass resulting in symptoms of cord compression that was diagnosed when aspects of our patient's initial magnetic resonance imaging scan did not correlate with disc herniation, which was the diagnosis with the greatest pretest probability.
Highlights
Spinal cord compression is a potentially devastating condition that demands immediate attention
We report a case of a spinal cord mass resulting in symptoms of cord compression that was diagnosed when aspects of our patient’s initial magnetic resonance imaging scan did not correlate with disc herniation, which was the diagnosis with the greatest pretest probability
Case presentation A 76-year-old Peruvian man presented to the emergency department for evaluation of one month of gradual onset of lower extremity weakness resulting in falls
Summary
Failure to recognize the presentation of multiple myeloma leads to delays and even errors in diagnosis and treatment. We do not suggest that a spinal mass resulting from multiple myeloma be kept at the forefront of the differential diagnosis of spinal cord compression. Rather, we present this case as an example of avoiding the anchoring heuristic by misdiagnosing lumbar disc protrusion [14]. Author details 1Department of Internal Medicine, Tulane University Health Sciences, New Orleans, Louisiana, 70112, US. KM was a major contributor in searching the current literature and writing the manuscript. Both authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests
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