Extraosseous epidural multiple myeloma presenting with thoracic spine compression.

Multiple myeloma is a hematopoetic disorder and multicentric disease, with the most common localisation being the spine. A 47-year-old male presented with progressive paraplegia, superficial and deep sensory disturbance below the level of T4. Spinal magnetic resonance image showed an epidural mass compressing the spinal cord at the level of T4-T6 with intact bone structure. The patient underwent surgical T4-T6 posterior spinal decompression. Microscopic examination and immunohistochemical studies confirmed the diagnosis of multiple myeloma of kappa subtype. Immunoelectrophoresis revealed the presence of immunoglobulin G kappa. The patient was subsequently started on steroids and chemotherapy for myeloma. Extraosseous epidural tumors causing compression myelopathy without evidence of destruction or collapse of vertebral bodies are relatively rare; to our knowledge only four cases have been reported in English literature.