Radiotherapy alleviates spinal cord compression caused by solitary bone plasmacytoma: A case report

Introduction and importance: Solitary bone plasmacytoma (SBP) is a hematopoietic malignancy occurring in bone tissue, which often causes bone destruction at the site of the lesion. When the lesion occurs in the spine and causes spinal stenosis and compression of the spinal cord, surgery is performed as an adjuvant treatment before radiotherapy. Case presentation: A 36-year-old patient suffered from neck, shoulder and upper limbs pain for 3 weeks and the symptom worsened for 3 days after exercise. CT and MRI examination of the neck after emergency admission revealed C5 vertebral pathological fracture with associated spinal stenosis and spinal cord compression. PET-CT indicated a hypermetabolic soft tissue mass in the C5-6 vertebral body. Granulomatous lesions (tuberculosis) were considered, but neoplastic lesions were not ruled out. The primary diagnosis was cervical fracture caused by tuberculosis. Finally, a needle biopsy was performed at the lesion site and a diagnosis of SBP was made. Radiotherapy was immediately followed and the spinal cord compression was relieved a month later. After 6 months of follow-up, she is now in stable condition with no neck pain or neurological impairment. Conclusion: For patients with SPB resulting in pathological fracture of the cervical vertebra with spinal stenosis and compression of the spinal cord, forgoing surgery and undergoing radiation therapy alone may be an option.