Solitary bone plasmacytoma compression injury disguised as back pain: a case report

Spinal Cord Series and Cases, 2019 · DOI: https://doi.org/10.1038/s41394-019-0161-4 · Published: January 27, 2019

Spinal Cord Injury Oncology Rehabilitation

Simple Explanation

Low back pain is a common issue, but sometimes it's caused by a serious condition like a tumor. This can delay the correct diagnosis. This report presents a case where a man's back pain was caused by a rare tumor called solitary bone plasmacytoma (SBP) compressing his spinal cord. The patient, initially diagnosed with unspecified back pain, experienced spinal cord compression due to the tumor. He underwent surgery and rehabilitation. The report details the medical, surgical, and rehabilitation treatments that led to his functional recovery. The authors suggest that persistent back pain, especially with neurological symptoms, should be thoroughly investigated with MRI to ensure a proper diagnosis and prompt treatment, particularly for serious underlying conditions.

Study Duration

Not specified

Participants

One 67-year-old male

Evidence Level

Level 4: Case Report

Key Findings

1
The patient, initially presenting with low back pain, was diagnosed with solitary bone plasmacytoma (SBP) causing spinal cord compression at T7-T9, leading to incomplete paraplegia.
2
Following surgical intervention (T7-T9 laminectomy and tumor resection) and intensive rehabilitation, the patient's condition improved from ASIA C to ASIA D, demonstrating functional recovery.
3
The case highlights the importance of considering rare underlying conditions like SBP in patients with persistent back pain, especially when accompanied by neurological symptoms, and emphasizes the potential for functional recovery with appropriate medical and rehabilitative management.

Research Summary

This case report describes a patient who presented with low back pain and was eventually diagnosed with solitary bone plasmacytoma (SBP) causing spinal cord compression. The patient underwent surgical intervention and an intensive rehabilitation program. The patient's condition improved from ASIA C to ASIA D following treatment. This case is unique because it provides a detailed description of the medical and rehabilitation diagnosis and treatment. The authors conclude that persistent back pain, particularly with neurological symptoms, warrants complete MRI spinal imaging to ensure proper diagnosis and prompt treatment. They also suggest that laminectomy and radiotherapy coupled with intensive rehabilitation may result in a more complete functional recovery.

Practical Implications

Diagnostic vigilance

Clinicians should consider rare underlying conditions like SBP in patients presenting with persistent back pain, particularly when neurological symptoms are present.

Importance of MRI

Complete MRI spinal imaging is warranted for patients with persistent back pain, especially when coupled with neurologic symptoms, to ensure proper diagnosis and prompt treatment.

Comprehensive treatment approach

Laminectomy and radiotherapy, when combined with an intensive rehabilitation regimen, may result in a more complete functional recovery in patients with SBP of the spine.

Study Limitations

1
Inconsistency in documentation of the gradual return of strength and sensation in the patient.
2
The long-term outcomes of the patient are still unknown as the patient is approximately 1.5 years post-diagnosis.
3
This case report is limited

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