Abstract
Introduction
Solitary bone plasmocytoma (SBP) is an uncommon entity. It represents 5 to 10% of all plasmatic cell neoplasms. Usually, it affects axial skeleton and rarely cervical spine.
Patient and Methods: A case report of a 73-year-old woman with 1.5 month of progressive neck pain with limitation of cervical mobility is presented. A nonsystematic literature review about cervical spine SBP was conducted.
Results
Cervical X-ray study showed a lytic lesion in C2 vertebral body with anterolisthesis of the atlas over the axis. Computed tomography scan confirmed complete destruction of C2 vertebral body with partial occupation of the spinal canal seen in the magnetic resonance imaging. The systemic tumor spread was discarded. The patient went for surgery with the diagnosis of a vertebral tumor lesion of C2. Posterior occipitocervical fixation of C0 to C5 with iliac crest autogenous bone graft and complementary fixation of the posterior arc of C1 to the placed rods with titanium cables was performed. Bone tumor biopsy using a posterior approach through the pedicle was done. Histological and immunohistochemical study resulted concordant with an SBP. Immediate postoperative was satisfactory, with disappearance of neck pain and with no neurological deficit. Six weeks after surgery, radiotherapy was conducted completing a total of 25 sessions with complete remission of SBP. Three years' follow-up, the patient presented no neck pain and no recurrence of disease. Seven years postoperative CT scan showed no signs of cervical SBP.
Conclusion
Spine SBP is a rare entity. It has a good prognosis depending on the correct and early diagnostic approach, which will offer the highest probability of therapeutic success. The main pillars of treatment are as follows: (1) spine stabilization surgery, complemented in some cases if necessary with decompression on neural elements and (2) radiotherapy.