title: Cervical spine metastasis of multiple myeloma: a case report with 16 years of follow-up.
abstract: METHODS
  Presented is a case report of a 16-year clinical course of a patient with a multiple myeloma of the third cervical vertebra.
  
  
  OBJECTIVE
  To describe a rare 16-year follow-up of a cervical multiple myeloma lesion that forced several surgical interventions.
  
  
  BACKGROUND
  Multiple myeloma is a systemic malignancy. It slowly causes bone destruction due to bone marrow infiltration. It is more common in the elderly and rarely affects the young. In patients with continuing neck pain and headache, one has to bear in mind the rare possibility of multiple myeloma or also other malignancies affecting the cervical spine.
  
  
  METHODS
  Clinical case analysis, radiographs, magnetic resonance images, and histological sections of the lesion are discussed. Repeated surgical interventions were required due to progressive disease.
  
  
  RESULTS
  Initial surgical treatment was aimed at palliation. However, this was in contrast to the slowly progressive clinical course. Thus, further surgical interventions were necessary. The patient died 16 years after the first procedure due to progression of the disease.
  
  
  CONCLUSIONS
  Even in young patients presenting with neck pain and minor neurological symptoms, one should bear in mind the rare possibility of multiple myeloma. At the very least, a radiograph of the cervical spine and a routine blood test should be performed. Surgical interventions must take into account the relatively long period of survival in multiple myeloma patients compared to patients with other secondary bone tumors.
authors.affiliation: Department of Orthopedics and Orthopedic Surgery, University of Rostock, Rostock, Germany. bernd-wegener@t-online.de
authors.forename: Bernd
authors.initials: B
authors.lastname: Wegener
authors.forename: Peter Ernst
authors.initials: PE
authors.lastname: Müller
authors.forename: Volkmar
authors.initials: V
authors.lastname: Jansson
authors.forename: Andreas
authors.initials: A
authors.lastname: Krödel
authors.forename: Gideon
authors.initials: G
authors.lastname: Heinert
authors.forename: Hans Roland
authors.initials: HR
authors.lastname: Dürr
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D009101:Multiple Myeloma / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology; D010166:Palliative Care; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D012447:Sacrum / Q000000981:diagnostic imaging; D013125:Spinal Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D013130:Spinal Stenosis / Q000209:etiology / Q000601:surgery; D013249:Sternum / Q000000981:diagnostic imaging; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed