Solitary bone plasmacytoma of spine with involvement of adjacent disc space

Abstract

Rationale Solitary bone plasmacytoma (SBP) is a rare manifestation of plasma cell tumor. Although axial skeleton is the most frequently affected site of SBP, adjacent disc space involvement is rare. Herein we report a case of SBP in thoracic vertebra with involvement of adjacent disc space. Patient concerns A 57-year-old male presented with a 2-year history of intermittent back pain with activity. The patient's back pain intensity with activity was a score of 5 of the 10-point visual analog scale). Diagnoses and intervention The patient underwent a posterior fusion procedure from T6 to T10, and an open biopsy of the vertebral lesion confirmed that final diagnosis of SBP. The patient received postoperative radiotherapy with a total of 4000 Gy to the T7–T9 vertebral levels over a 20-day period. Outcomes Following radiotherapy, the patient's pain intensity was reduced to the visual analog scale score of 1 at the 6-month follow-up. Lessons SBP lacks typical clinical symptoms, and the accurate diagnosis before clinical intervention remains challenging. Due to the disc involvement, SBP often manifests as spinal infection. Hence, differential diagnosis in spinal lesions involving the disc should include SBP.

Solitary bone plasmacytoma of the axis, a rare and challenging case with good outcomes

“…Among spine involvement, the thoracic spine is the most commonly affected location [ 4 ]. The upper cervical spine is rarely involved and represent a more challenging condition due to the risk of CVJ instability [ 5 ].…”