Background
Multiple myeloma (MM) is hematological cancer characterized by the growth of malignant plasma cells of B-cell lineage which are found in the bone marrow and secrete immunoglobulins (Ig) [1, 2, 3], The illness mostly affects the bones, although it can also affect the lymphatic nodes and epidermis. MM is an incurable disease [3], which is also one of the most prevalent cancers that affect the spine [4]. In France, approximately 5000 new cases are detected each year [2], while in the United States, MM represents around 1.6 percent of all malignant tumors and almost 10% of hematologic malignancies [1, 5, 6]. Males are somewhat more likely than females to have MM and African-Americans are twice as likely as Caucasians to develop the disease, The patient’s median age at the time of discovery is around 65 years old [1, 6]. Some of the most common clinical signs (seen in 80% of patients) are refractory pain, fracture, vertebral collapse, or spinal cord compression due to bone lysis. Anemia, hypercalcemia, renal dysfunction, recurring infections, and hyperviscosity are some symptoms of its progression [2, 6, 7]. One of the pathognomonic and diagnostic hallmarks of MM is bone injury, which appears as an osteolytic bone disease (OBD) or osteopenia [7], OBD affects approximately 90% of patients with MM [7, 8]. Because of that injury in MM patients, imaging plays an important role in disease management. Magnetic resonance imaging (MRI) has proven to be a useful tool in the diagnosis of MM bone lesions [8]. Clinical, radiographic, histopathologic, and laboratory findings are frequently used to diagnose MM. Back pain, vertebral fractures, paresthesia, and paresis owing to spinal cord compression are the most common symptoms of axial skeleton metastases in symptomatic patients. Hypercalcemia can develop from lytic bone lesions, and renal failure might manifest as anemia and proteinuria. The International Myeloma Working Group (IMWG) established calcium elevation, renal dysfunction, anemia, and bone disease (CRAB) acronym to describe the clinical symptoms of MM and to distinguish it from other plasma cell dyscrasias such as solitary plasmacytoma [5]. For a long time, prednisone, melphalan, and other corticosteroids were used to treat MM [9, 10], Proteasome inhibitor medications like Velcade (bortezomib), in conjunction with dexamethasone (the VD regimen), have been utilized to treat MM for the past 20 years. Velcade (bortezomib) and dexamethasone were typically combined with cyclophosphamide, adriamycin, or even thalidomide (VTD) to increase efficacy [9, 10]. In this study, we report a case of MM which was complicated with spinal cord metastasis.