Successful bortezomib treatment in combination with dexamethasone and thalidomide for previously untreated epidural plasmacytoma

Abstract

Epidural plasmacytoma is a rare clinical entity of plasma cell neoplasms. The optimal management of extramedullary plasmacytoma remains unclear, particularly for bulky masses. In this study, we report the case of a 35-year-old male who presented with the inability to walk, urinary incontinence and superficial and deep sensory disturbance. Spinal magnetic resonance imaging revealed a large epidural mass compressing the spinal cord at the level of T2-T4. The patient underwent surgical T2-T4 vertebral canal decompression. Histopathological examination and other fndings confrmed the diagnosis of extramedullary plasmacytoma. The patient was treated with bortezomib in combination with dexamethasone and thalidomide. Following 4 cycles of chemotherapy, the patient achieved an excellent clinical response. Over 1year following the initial diagnosis, the patient was in complete remission with no evidence of local relapse or evolution to multiple myeloma. This is the frst case of a previously untreated epidural plasmacytoma, which was successfully treated with bortezomib-containing chemotherapy.