Unilateral diaphragm paralysis possibly due to cervical spine involvement in multiple myeloma

Med Princ Pract. 2006;15(3):242-4. doi: 10.1159/000092191.

Abstract

Objective: To describe a patient with unilateral diaphragmatic paralysis due to multiple myeloma (MM) involving the cervical spine and related structures.

Case presentation and intervention: A 52-year-old female presented with dyspnea, low back and widespread bone pain. She was diagnosed as having MM with vertebral involvement and unilateral paralysis of the diaphragm. She received two cycles of a chemotherapeutic regimen consisting of vincristine-Adriamycin-dexamethasone. The bisphosphonate zoledronic acid was also initiated at the same time. During follow-up, the back pain disappeared and the complaint of dyspnea decreased, although the paralysis persisted.

Conclusion: As part of the differential diagnosis of bone and back pain, we draw attention to MMand the rare complication of diaphragmatic paralysis due to phrenic nerve involvement.

Publication types

  • Case Reports

MeSH terms

  • Cervical Vertebrae*
  • Diaphragm*
  • Female
  • Humans
  • Middle Aged
  • Multiple Myeloma / complications*
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / therapy
  • Paralysis / etiology*
  • Spinal Neoplasms / complications*
  • Spinal Neoplasms / diagnosis
  • Spinal Neoplasms / therapy
  • Thoracic Vertebrae*