BMJ Case Reports 2018; doi:10.1136/bcr-2018-227546
  • Images in…

Case of solitary plasmacytoma of tibia

  1. Vidya Monappa2
  1. 1Orthopaedics, Manipal Academy of Higher Education, Manipal, Karnataka, India
  2. 2Pathology, Manipal Academy of Higher Education, Manipal, Karnataka, India
  1. Correspondence to Dr Sandesh Madi, sandesh.madi{at}
  • Accepted 18 September 2018
  • Published 7 October 2018


A 58-year-old diabetic man presented to the outpatient department with pain in his right leg of 6 months’ duration. The pain was insidious in onset and gradually progressive. He was unable to bear weight on the affected side. On clinical examination, there was tenderness over the medial aspect of the upper part of the leg. The knee range of movements was limited and painful. The distal neurovascular examination was normal.

Plain X-ray of the knee (figure 1) showed an eccentric lytic lesion in the proximal end of the tibia with a pathological fracture of the medial wall. There was no periosteal reaction. Plain and contrast MRI study (figure 2) revealed a well-defined heterogeneously enhancing altered signal eccentric intramedullary lesion in the proximal metadiaphyseal region of the tibia with cortical breaks. The patient was taken up for open incisional biopsy, and prophylactic fixation …

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