title: Cervical epidural plasmacytoma presenting as ascending paraparesis.
abstract: BACKGROUND
  Spinal epidural plasmacytomas are very rare and are usually localized in the cervicothoracic and lumbar spines.
  
  
  OBJECTIVE
  To present the first case of cervical dural plasmacytoma and discuss the treatment options for this entity.
  
  
  METHODS
  Case report and review of the literature.
  
  
  METHODS
  A 45-year-old man presented with gradually progressive legs to arms numbness preceded by upper respiratory tract infection and followed by rapid flaccid quadriparesis over 1 week. Because of the above symptoms, he was initially thought to have Guillain-Barré syndrome, but this diagnosis was ruled out by an emergency normal nerve conduction studies and needle electromyography. Cervical magnetic resonance imaging revealed an enhancing epidural mass at the C4-C7 level on T1-weighted images and increased signal on T2, causing spinal cord compression. Complete surgical evacuation was performed. Subsequent histology revealed plasmacytoma associated with anaplastic multiple myeloma, and the patient was referred to the hematology department for further treatment.
  
  
  RESULTS
  Follow-up at 9 and 13 months after surgery revealed complete remission of the primary disease (multiple myeloma). The patient was neurologically improved and ambulatory with unilateral support.
  
  
  CONCLUSIONS
  The reported case describes the first epidural extramedullary plasmacytoma isolated in the cervical spine in the English literature. Emergent neuroimaging and surgery can dramatically affect prognosis of this rare spinal neoplasm.
authors.affiliation: B' Department of Neurology, AHEPA University Hospital, Stilponos Kyriakides 1 Street, Thessaloniki, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Lourbopoulos
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Ioannidis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Balogiannis
authors.forename: Pantelis
authors.initials: P
authors.lastname: Stavrinou
authors.forename: Triantafyllia
authors.initials: T
authors.lastname: Koletsa
authors.forename: Dimitris
authors.initials: D
authors.lastname: Karacostas
mesh_terms: D002574:Cervical Vertebrae / Q000473:pathology*; D003937:Diagnosis, Differential; D015174:Epidural Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D020335:Paraparesis / Q000175:diagnosis* / Q000209:etiology; D012074:Remission Induction