Polyradiculoneuropathy revealing a solitary plasmacytoma of the ilium - A new case-report

Neurological manifestations are uncommon in myeloma patients, and subacute polyradiculoneuropathy as the inaugural manifestations of solitary plasmacy toma of bone is exceedingly rare. We report the case of a 52-year-old man w ho was evaluated for a three-month history of flaccid tetraplegia with a gr adually ascending onset and for a deterioration in general health. Electrom yography findings were consistent with polyradiculoneuropathy. Laboratory t ests showed a moderate amount of a monoclonal IgG-lambda antibody. Findings were normal from a radiographic bone survey and a radionuclide bone scan. Computed tomography of the pelvis disclosed a solitary osteolytic lesion in the right iliac crest, which was found upon biopsy to be a malignant plasm acytoma, Radiation therapy and chemotherapy were given. Subacute or chronic polyradiculoneuropathy as the inaugural manifestation of solitary plasmacy toma is exceedingly rare and should be distinguished from the sensorimotor polyneuropathy produced by plasma cell infiltration in some multiple myelom a patients. The polyradiculoneuropathy of solitary plasmacytoma can be like ned to the neuropathies seen in some forms of multiple myeloma (sclerotic m yeloma and POEMS syndrome). The pathophysiology of these neuropathies remai ns obscure. The case reported here suggests that patients with unexplained lasting polyradiculoneuropathy should be investigated for a plasma cell pro liferation even If they have no serum monoclonal component. Because plasmac ytomas are painless, Imaging studies are needed for their diagnosis. The ma nagement of the neuropathy consists in treatment of the tumor.