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IgA multiple myeloma-associated mediastinal spinal plasmacytoma presenting as spinal cord compression
  1. Sruti Prathivadhi-Bhayankaram1,
  2. Rosalyn Marar2,
  3. Samir Atiya2 and
  4. Mridula Krishnan2
  1. 1Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  2. 2University of Nebraska Medical Center, Omaha, Nebraska, USA
  1. Correspondence to Dr Sruti Prathivadhi-Bhayankaram; sruti.prathivadhi{at}


Multiple myeloma associated with extramedullary plasmacytoma at initial presentation is rare. We describe a case of a man in his 30s who initially presented with symptoms of spinal cord compression. Further imaging revealed a mediastinal tumour, with a biopsy confirming plasmacytoma. Immunofixation revealed IgA lambda paraprotein. Bone marrow biopsy demonstrated atypical T-cell cytotoxic proliferation and trilineage hypoplasia. The patient was diagnosed with extramedullary plasmacytoma with active IgA multiple myeloma. The patient received mediastinal radiation to the tumour, followed by anti-myeloma therapy. This diagnosis is critical as managing a solitary plasmacytoma drastically differs from an extramedullary plasmacytoma with active multiple myeloma.

  • Oncology
  • End of life decisions (palliative care)
  • Radiotherapy

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: SP-B, RM, SA and MK. The following authors gave final approval of the manuscript: SP-B, MD RM, SA and MK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.