Near-miss Thoracic Spine Solitary Plasmacytoma with Neurological Deficit during Pregnancy: A Case Report
https://doi.org/10.5704/MOJ.2211.022
- Author:
Teh KH
1
;
Thilak J
2
;
Lim HS
2
;
Yahaya AA
1
;
Kamarul-Bahrin ZA
2
Author Information
1. Department of Orthopaedics, Hospital Seberang Jaya, Permatang Pauh, Malaysia
2. Department of Orthopaedics, Hospital Pulau Pinang, George Town, Malaysia
- Publication Type:Case Reports
- Keywords:
plasmacytoma, solitary spinal tumour, pregnancy, spine surgery
- From:Malaysian Orthopaedic Journal
2022;16(No.3):139-142
- CountryMalaysia
- Language:English
-
Abstract:
Solitary plasmacytoma (SPC) account for only 5% of plasma
cell neoplasms, and the literature hardly reports spinal SPC
with a neurological deficit. Furthermore, spinal surgical
intervention during pregnancy is rarely encountered and
often requires multidisciplinary collaboration and
management. The objective of this case report is to highlight
this near-miss diagnosis and spinal surgical intervention
during pregnancy. A 31-year-old woman with 24 weeks
gestation presented with sudden paralysis and incontinence,
with an underlying history of chronic backpain over a twomonth period. Initially, she was treated for musculoskeletal
back pain by obstetric colleagues during an antenatal visit,
and no radiograph was performed. A non-contrasted spinal
MRI was eventually requested when she started to show
bilateral lower limb weakness, numbness and incontinence.
The MRI highlighted thoracic vertebrae T11 vertebra plana
with kyphotic deformity and a paraspinal soft tissue mass
compressing the spinal cord causing spinal cord oedema.
Our initial working diagnosis was spinal tuberculosis (TB),
considering TB is highly endemic in Malaysia. However, TB
workup was negative, and we proceeded with spinal surgery
and transpedicular biopsy. Neurology improved significantly
after surgery. Eventually, serum protein electrophoresis
reported plasma dyscrasia, and HPE confirmed
plasmacytoma. The patient was referred to a haematologist
for steroidal and chemotherapy treatment.
- Full text:16.2022my1286.pdf
