Diário da Espinha

Tuberculous Spondylitis and Coincidental Spinal Multiple Myeloma: A Case Report

Abstract

Prinsen SD, Groot D, Oude Lashof AML and Willems PC

Background content: Tuberculous spondylitis (Pott’s disease) is known for nonspecific findings which can mimic metastatic disease. Spinal pain, local tenderness and night sweats may be presenting symptoms. There is no pathognomic radiographic appearance of tuberculous spondylitis.

Back pain may also be the first sign of multiple myeloma (MM) and is usually caused by bone destruction or vertebral collapse. The tumour itself can also cause pain by nerve or spinal cord damage resulting from direct pressure or secondary peripheral neuropathies. MM is often complicated by infectious diseases caused by the mainly cell mediated and humoral immune deficiency.

Purpose: To report a case of a patient who presented with Pott’s disease and multiple myeloma in the same vertebra.

Study Design: Case Report Patient Sample: Description of one case Outcome measures: Multiple myeloma and Pott’s disease can coincide. If one of these diseases is overlooked, it may have serious consequences for the patient.

Methods: We present a case of a patient with Pott’s disease and multiple myeloma in the same vertebra. This is shown on radiographic findings, laboratory results and pathologic findings.

Results: Radiographic findings, laboratory results and pathologic findings showed a Pott’s disease and multiple myeloma in the same vertebra.

Conclusion: We present a patient with persisting back pain, who was initially diagnosed with spinal tuberculosis. Despite antituberculous medication he developed signs of spinal cord compression and was operated on. Retrieved tissue samples revealed multiple myeloma.

This case highlights that, as MM may predispose for active TB, the two diagnoses may coincide. Because of similarity of clinical appearance one of them may be overlooked, which may have serious consequences for the patient.