Myélome multiple épidural extra-osseux révélé par une compression médullaire dorsale

Revue du Rhumatisme 01/2008; 75(1):74-76. DOI: 10.1016/j.rhum.2007.01.026


Le myélome multiple est une hémopathie maligne multifocale qui touche préférentiellement le rachis. Un homme de 47 ans a été hospitalisé pour une paraplégie progressive, accompagnée de troubles sensitifs superficiels et profonds, de niveau D4. L’imagerie par résonance magnétique a mis en évidence une masse épidurale qui comprimait la moelle entre D4 et D6. L’os était intact. Une décompression postérieure de D4 à D6 a été réalisée. L’histologie avec marquage immunohistochimique a mis en évidence un myélome multiple à chaînes kappa. Une immunoglobuline G kappa monoclonale a été mise en évidence par immunoélectrophorèse des protéines sériques. Les tumeurs épidurales extra-osseuses responsables de compression médullaire en l’absence de destruction ou de tassement vertébral sont rares. À notre connaissance, seuls quatre cas ont été décrits dans la littérature médicale anglophone.

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