Plasmacytoma of the Cervical Spine: A Case Study
SOURCE: J Chiropractic Medicine 2017 (Jun); 16 (2): 170–174
Richard Pashayan, DC, DABCO, CCSP,
Wesley M. Cavanaugh, DC,
Chad D. Warshel, DC, DACBR, and
David R. Payne, MD
OBJECTIVE: The purpose of this case study is to describe the presentation of a patient with plasmacytoma.
CLINICAL FEATURES: A 49-year-old man presented with progressive neck pain, stiffness, and dysphagia to a chiropractic office. A radiograph indicated a plasmacytoma at C3 vertebral body. The lesion was expansile and caused a mass effect anteriorly on the esophagus and posteriorly on the spinal cord. Neurologic compromise was noted with fasciculations and hypesthesia in the right forearm. The patient was referred to a neurosurgeon.
INTERVENTION AND OUTCOME: Surgical resection of the tumor was performed with a vertebral body spacer and surrounding titanium cage. Bony fusion was initiated by inserting bone grafts from the iliac crests into the titanium cage. Additional laboratory analysis and advanced imaging confirmed that the plasmacytoma had progressed to multiple myeloma and radiation and chemotherapy were also necessary.
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