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Updated: May 11, 2026

Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
IgA multiple myeloma-associated mediastinal spinal plasmacytoma presenting as spinal cord compression
Sruti Prathivadhi-Bhayankaram1, Rosalyn Marar2, Samir Atiya2
1Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA sruti.prathivadhi@gmail.com.
Abstract:
Multiple myeloma associated with extramedullary plasmacytoma at initial presentation is rare. We describe a case of a man in his 30s who initially presented with symptoms of spinal cord compression. Further imaging revealed a mediastinal tumour, with a biopsy confirming plasmacytoma. Immunofixation revealed IgA lambda paraprotein. Bone marrow biopsy demonstrated atypical T-cell cytotoxic proliferation and trilineage hypoplasia. The patient was diagnosed with extramedullary plasmacytoma with active IgA multiple myeloma. The patient received mediastinal radiation to the tumour, followed by anti-myeloma therapy. This diagnosis is critical as managing a solitary plasmacytoma drastically differs from an extramedullary plasmacytoma with active multiple myeloma.
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