Chest Pain Caused by Thoracic Spine Plasmacytoma: A Case Report

Area of Science:

• Oncology
• Cardiology
• Neurology

Background:

• Chest pain is a common symptom with multifactorial causes, often initially investigated for cardiac origins, especially in patients with comorbidities.
• Coronary artery disease is a frequent cause of chest pain, particularly in individuals with risk factors such as comorbidities.
• Spinal masses can present with varied symptoms, including chest pain, though they are less commonly considered in initial differential diagnoses.

Observation:

• A patient presented with chest pain, initially suspected to be related to coronary artery disease due to pre-existing comorbidities.
• During a Lexiscan stress test, an unexpected thoracic spinal mass was incidentally discovered.
• The incidental finding of the spinal mass prompted a re-evaluation of the chest pain etiology.

Findings:

• The thoracic spinal mass was diagnosed as a rare presentation of multiple myeloma.
• The case underscores that chest pain can originate from non-cardiac sources, including spinal pathologies.
• Diagnostic workup for chest pain should encompass a broad differential diagnosis, considering less common etiologies.

Implications:

• This case emphasizes the importance of considering a wide range of differential diagnoses for chest pain, beyond typical cardiac causes.
• It highlights the diagnostic challenge posed by rare presentations of conditions like multiple myeloma.
• Physicians should maintain a high index of suspicion for alternative diagnoses when initial investigations do not fully explain symptoms.