IgA multiple myeloma-associated mediastinal spinal plasmacytoma presenting as spinal cord compression

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Multiple myeloma (MM) is a malignant plasma cell disorder.
• Extramedullary plasmacytoma (EMP) involves plasma cell tumors outside the bone marrow.
• Concurrent EMP and active MM at initial diagnosis is exceptionally uncommon.

Observation:

• A young adult male presented with spinal cord compression.
• Imaging revealed a mediastinal mass, confirmed as plasmacytoma via biopsy.
• Laboratory findings included IgA lambda paraprotein and bone marrow abnormalities.

Findings:

• The patient was diagnosed with extramedullary plasmacytoma and active IgA multiple myeloma.
• Bone marrow biopsy showed atypical T-cell proliferation and trilineage hypoplasia.
• This presentation underscores the complexity of plasma cell neoplasms.

Implications:

• Accurate diagnosis is crucial, as management differs significantly between solitary plasmacytoma and EMP with active MM.
• Early recognition of concurrent extramedullary disease and active myeloma is vital for appropriate treatment planning.
• This case emphasizes the need for thorough evaluation in patients presenting with seemingly isolated extramedullary masses.