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以突发截瘫为表现的多发性骨髓瘤

Multiple Myeloma Presenting With Sudden Paraplegia.

作者信息

Veiga Hugo, Almeida Manuel, Duarte Pedro, Paiva José Artur, Monteiro Elisabete

机构信息

Intensive Care Department, Hospital de São João, Porto, PRT.

Intensive Care Department, Hospital de Portimão, Portimão, PRT.

出版信息

Cureus. 2025 Jun 20;17(6):e86415. doi: 10.7759/cureus.86415. eCollection 2025 Jun.

Abstract

Multiple myeloma (MM) is a malignant neoplasia predominantly characterized by systemic manifestations, but atypical presentations can challenge diagnosis and management, as in the case of solitary plasmacytoma. We present a case of a 60-year-old woman with sudden paraplegia due to a solitary dorsal spinal mass compressing the spinal cord. Emergent surgical decompression prevented further neurological deterioration, but permanent paraplegia remained. This case underlines the importance of recognizing atypical presentations of multiple myeloma, such as solitary spinal lesions, which may mimic other conditions. Early diagnosis and intervention are crucial to prevent irreversible neurological sequelae. Prompt surgical decompression, followed by systemic therapy, can optimize outcomes in patients with this pathology. Multidisciplinary collaboration and aggressive management of complications, as well as early rehabilitation, are also essential to address the complex needs of these patients and improve outcomes.

摘要

多发性骨髓瘤(MM)是一种主要以全身表现为特征的恶性肿瘤,但非典型表现可能会对诊断和治疗构成挑战,孤立性浆细胞瘤的情况就是如此。我们报告一例60岁女性病例,该患者因孤立性胸段脊髓肿块压迫脊髓而突发截瘫。紧急手术减压防止了神经功能进一步恶化,但截瘫仍持续存在。该病例强调了认识多发性骨髓瘤非典型表现(如孤立性脊柱病变)的重要性,这些表现可能会与其他疾病相混淆。早期诊断和干预对于预防不可逆的神经后遗症至关重要。及时进行手术减压,随后进行全身治疗,可以优化患有这种疾病的患者的治疗效果。多学科协作、积极处理并发症以及早期康复对于满足这些患者的复杂需求和改善治疗效果也至关重要。

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