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Single-stage 360° Reconstruction in a Case of Solitary Vertebral Plasmacytoma of L3 vertebra – A Case Report

INTRODUCTION: Malignant bone tumors of the spine are extremely rare with an incidence of 0.05% of primary neoplasms. Solitary plasmacytoma of the vertebra accounts for about 30% of the total within this group. CASE PRESENTATION: A 23-year-old female presented to spine clinic, with complaints of low...

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Autores principales: Moger, Nagaraj Manju, Ifthekar, Syed, Ahuja, Kaustubh, Mittal, Samarth, Pragadeeshwaran, J, Kandwal, Pankaj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815668/
https://www.ncbi.nlm.nih.gov/pubmed/33489963
http://dx.doi.org/10.13107/jocr.2020.v10.i06.1860
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author Moger, Nagaraj Manju
Ifthekar, Syed
Ahuja, Kaustubh
Mittal, Samarth
Pragadeeshwaran, J
Kandwal, Pankaj
author_facet Moger, Nagaraj Manju
Ifthekar, Syed
Ahuja, Kaustubh
Mittal, Samarth
Pragadeeshwaran, J
Kandwal, Pankaj
author_sort Moger, Nagaraj Manju
collection PubMed
description INTRODUCTION: Malignant bone tumors of the spine are extremely rare with an incidence of 0.05% of primary neoplasms. Solitary plasmacytoma of the vertebra accounts for about 30% of the total within this group. CASE PRESENTATION: A 23-year-old female presented to spine clinic, with complaints of low back pain, deformity in lower back, and difficulty in walking for 3 months duration. Radiological investigations revealed destruction of L3 vertebra with soft-tissue mass around it. USG-guided biopsy from the lesion was suggestive of plasma cell dyscrasia. Routine blood investigations showed no abnormality. Urine myeloma profile and immunoelectrophoresis were done which were within normal limit and ruled out multiple myeloma. Due to the profound neurological deficit and existing instability, the patient underwent decompression, resection of tumor, anterior column reconstruction with cage, and instrumented posterior and posterolateral fusion (360° fusion) from L1-L5, before radiotherapy. The patient was subjected to 23 cycles of intensity-modulated radiotherapy and is doing good on subsequent follow-ups with good fusion. CONCLUSION: Solitary plasmacytoma of vertebra when associated with neurological deficit and/or instability should be treated with spinal stabilization surgery followed by radiotherapy to achieve good and overall predictable outcomes.
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spelling pubmed-78156682021-01-21 Single-stage 360° Reconstruction in a Case of Solitary Vertebral Plasmacytoma of L3 vertebra – A Case Report Moger, Nagaraj Manju Ifthekar, Syed Ahuja, Kaustubh Mittal, Samarth Pragadeeshwaran, J Kandwal, Pankaj J Orthop Case Rep Case Report INTRODUCTION: Malignant bone tumors of the spine are extremely rare with an incidence of 0.05% of primary neoplasms. Solitary plasmacytoma of the vertebra accounts for about 30% of the total within this group. CASE PRESENTATION: A 23-year-old female presented to spine clinic, with complaints of low back pain, deformity in lower back, and difficulty in walking for 3 months duration. Radiological investigations revealed destruction of L3 vertebra with soft-tissue mass around it. USG-guided biopsy from the lesion was suggestive of plasma cell dyscrasia. Routine blood investigations showed no abnormality. Urine myeloma profile and immunoelectrophoresis were done which were within normal limit and ruled out multiple myeloma. Due to the profound neurological deficit and existing instability, the patient underwent decompression, resection of tumor, anterior column reconstruction with cage, and instrumented posterior and posterolateral fusion (360° fusion) from L1-L5, before radiotherapy. The patient was subjected to 23 cycles of intensity-modulated radiotherapy and is doing good on subsequent follow-ups with good fusion. CONCLUSION: Solitary plasmacytoma of vertebra when associated with neurological deficit and/or instability should be treated with spinal stabilization surgery followed by radiotherapy to achieve good and overall predictable outcomes. Indian Orthopaedic Research Group 2020-09 /pmc/articles/PMC7815668/ /pubmed/33489963 http://dx.doi.org/10.13107/jocr.2020.v10.i06.1860 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Moger, Nagaraj Manju
Ifthekar, Syed
Ahuja, Kaustubh
Mittal, Samarth
Pragadeeshwaran, J
Kandwal, Pankaj
Single-stage 360° Reconstruction in a Case of Solitary Vertebral Plasmacytoma of L3 vertebra – A Case Report
title Single-stage 360° Reconstruction in a Case of Solitary Vertebral Plasmacytoma of L3 vertebra – A Case Report
title_full Single-stage 360° Reconstruction in a Case of Solitary Vertebral Plasmacytoma of L3 vertebra – A Case Report
title_fullStr Single-stage 360° Reconstruction in a Case of Solitary Vertebral Plasmacytoma of L3 vertebra – A Case Report
title_full_unstemmed Single-stage 360° Reconstruction in a Case of Solitary Vertebral Plasmacytoma of L3 vertebra – A Case Report
title_short Single-stage 360° Reconstruction in a Case of Solitary Vertebral Plasmacytoma of L3 vertebra – A Case Report
title_sort single-stage 360° reconstruction in a case of solitary vertebral plasmacytoma of l3 vertebra – a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815668/
https://www.ncbi.nlm.nih.gov/pubmed/33489963
http://dx.doi.org/10.13107/jocr.2020.v10.i06.1860
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