Multiple Myeloma Presenting as Spinal Cord Compressive Plasmacytoma in Young Adults: A Case Series

Multiple myeloma is a hematologic malignancy characterized by clonal proliferation of plasma cells. It is rare in young adults and may present in atypical forms, complicating timely diagnosis.

Patient 1 was a 23-year-old female who presented with subacute onset of leg pain, progressive weakness, and urinary retention. Lumbar spine magnetic resonance imaging (MRI) revealed a sacral mass causing cauda equina syndrome. Biopsy confirmed the diagnosis of plasmacytoma. At discharge, she exhibited gait abnormalities, neuropathic pain, and persistent urinary retention. She functioned at a modified independent level, using a manual wheelchair for mobility and performing intermittent self-catheterization. Patient 2 was a 28-year-old female who presented with acute onset of leg pain, weakness, and urinary retention. MRI of the spine revealed an epidural mass extending from T1 to T11, resulting in spinal cord compression. She underwent thoracolumbosacral laminectomies, and biopsy confirmed plasmacytoma. At discharge, she had motor complete paraplegia, neuropathic pain, and urinary retention managed with intermittent self-catheterization. She was modified independent, using a manual wheelchair for mobility.

Despite advances in diagnosis and treatment, multiple myeloma remains a complex disease that poses diagnostic and therapeutic challenges. These cases emphasize the importance of standardized treatment protocols in management of spinal cord compressive plasmacytoma.

Early diagnosis, coordinated multidisciplinary care, and comprehensive rehabilitation are essential for improved management and outcomes.