Lessons to be learned: a case study approach - Extramedullary plasmacytomapresenting as upper back pain

Extramedullary plasmacytoma (EMP) is a rare soft tissue plasma cell tumour, usually presenting as a mass within the upper respiratory tract. It is mos t unusual for it to present in the posterior mediastinum as a primary solit ary lesion. Discussed here is the case report of a patient who initially pr esented with musculoskeletal pain. Subsequent investigations, however, reve aled the cause to be an EMP; diagnosis was made on finding aggregates of pl asma cells on histological examination of the tissue specimen. The latter h ad been obtained by way of a computerised tomography scan guided biopsy of the tumour. Bone marrow aspiration studies showed no evidence of multiple m yelomatosis. There was significant clinical improvement in response to radi otherapy. It is possible that this might represent one of the first documen ted reports of a primary solitary EMP in the posterior mediastinum.