Solitary Plasmacytoma of the Spine: An Unusual Presentation

Solitary plasmacytoma of bone (SBP) is a rare hematologic malig-nancy, which occurswith radiologic evidence of a solitary lesion in the absence of significant bone marrow plasma cell infiltration (5%– 10%), leading to absent (or low) serum and urine levels of monoclo-nal protein.1 This isolated lesion is most commonly found in the spine, without evidence of multiple myeloma elsewhere.2-4 Our letter will present a biopsy-proved thoracolumbar SBP with extensive in-volvement of the soft tissues. A 41-year-old woman presented with back pain, paraparesis, and hyporeflexia of the lower limbs. Spine CT revealed osteolytic areas from T12 to L2 with vertebrae and disk-space destruction, extension to the posterior elements (Fig 1A), and a perivertebral mass (Fig 1B). MR imaging showed extension of the lesion to the spinal canal, with an importantmildly enhancing epiduralmass and compression of the cord. CT-guided bone marrow vertebral biopsy was consistent wit