Multiple myeloma

Case contributed by Allison L Zwingenberger

Presentation

10 year old male neutered Viszla. The patient has a six week history of cervical pain and progressive pelvic limb paresis. Tentative Diagnosis: C1-T2 lesion, possible C5-cranial.

Patient Data

Age: 10
Gender: Castrated male
Category: Domestic dog
Organism: Vizsla superbreed

Vertebral column

x-ray

There is a mineralized disc in situ at the C6-7 intervertebral disc space. The body of C7 is shortened and is radiolucent, with thin cortices. The body of C3 is sclerotic compared to surrounding vertebrae. There is enlargement of the facet joints at C4-C7. The patient is under general anesthesia with an endotracheal tube in place, and a small amount of fluid and gas in the esophagus.

Thoracic spine

mri

An MRI was performed, and contrast enhancing tissue was found in multiple cervical and thoracic vertebrae as well as in the spinal canal and venous sinuses. The C7 and T1-T3 vertebral bodies are contrast enhancing.

Spine

pathology

There is a compression fracture of the vertebral body with central lysis. A soft tissue component extends into the spinal canal.

Case Discussion

Differential diagnosis

Lucency of C7 and sclerosis of T3 are most consistent with an aggressive process such as neoplasia. A multicentric or metastatic myeloma, or other metastatic neoplasia (carcinoma, hemangiosarcoma, lymphoma) could also be considered. The degenerative intervertebral disc disease may be incidental.

 

 


Diagnosis

Multiple myeloma.


Discussion

An MRI was performed, and contrast enhancing tissue was found in multiple cervical and thoracic vertebrae as well as in the spinal canal and venous sinuses.

Necropsy examination found myeloma at these sites as well as invasion of the venous sinuses.


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