Successful bortezomib treatment in combination with dexamethasone and thalidomide for previously untreated epidural plasmacytoma

Abstract

Epidural plasmacytoma is a rare clinical entity of plasma cell neoplasms. The optimal management of extra medullary plasmacytoma remains unclear, particularly for bulky masses. In this study, we report the case of a 35-year-old male who presented with the inability to walk, urinary incontinence and superficial and deep sensory disturbance. Spinal magnetic resonance imaging revealed a large epidural mass compressing the spinal cord at the level of T2-T4. The patient underwent surgical T2-T4 vertebral canal decompression. Histopathological examination and other findings confirmed the diagnosis of extramedullary plasmacytoma. The patient was treated with bortezomib in combination with dexamethasone and thalidomide. Following 4 cycles of chemotherapy, the patient achieved an excellent clinical response. Over 1 year following the initial diagnosis, the patient was in complete remission with no evidence of local relapse or evolution to multiple myeloma. This is the first case of a previously untreated epidural plasmacytoma, which was successfully treated with bortezomib-containing chemotherapy.