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CASE REPORT
Year : 2017  |  Volume : 1  |  Issue : 2  |  Page : 40-43

Plasmacytoma of C1 and C2 in an elderly female: The impediments in proper management in a Rural Tertiary Care Hospital


Department of Neurosurgery, College of Medical Sciences - Teaching Hospital, Bharatpur, Chitwan, Nepal

Correspondence Address:
Joe M Das
Department of Neurosurgery, College of Medical Sciences - Teaching Hospital, Bharatpur, P. O. Box: 23, Chitwan
Nepal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/EJSS.EJSS_11_17

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Solitary plasmacytoma arising as a primary bone tumor at the craniovertebral junction is very rare, with only a few cases reported in the literature. Here, we present a 62-year-old female who presented with complaints of neck pain and restricted neck movements of short duration. She had features of upper motor neuron involvement in all the limbs, but the motor power was preserved with no bladder symptoms. The magnetic resonance imaging of the cervical spine revealed an expansile lytic lesion at the craniovertebral junction, involving the C2 vertebral body and posterior elements of C1 and C2. The bulk of the mass was extending posteriorly and compressing the cord. Since there was a chance of neurological deterioration due to the extensive anterior and posterior column involvement, we went ahead with surgical decompression of the lesion posteriorly. The posterior component was near totally decompressed, and the spine was stabilized with occiput-C3 fixation and fusion using rib grafts and steel wires due to financial constraints. The postoperative period was uneventful, and she was followed up for 2 months during which there was no neurological deterioration. Subsequently, she was lost to follow-up. She did not undergo radiation therapy or myeloma workup due to financial limitation. The histopathological examination of the lesion revealed plasmacytoma.


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