Abstract
Multiple myeloma (MM) is a malignant neoplasia predominantly characterized by systemic manifestations, but atypical presentations can challenge diagnosis and management, as in the case of solitary plasmacytoma. We present a case of a 60-year-old woman with sudden paraplegia due to a solitary dorsal spinal mass compressing the spinal cord. Emergent surgical decompression prevented further neurological deterioration, but permanent paraplegia remained. This case underlines the importance of recognizing atypical presentations of multiple myeloma, such as solitary spinal lesions, which may mimic other conditions. Early diagnosis and intervention are crucial to prevent irreversible neurological sequelae. Prompt surgical decompression, followed by systemic therapy, can optimize outcomes in patients with this pathology. Multidisciplinary collaboration and aggressive management of complications, as well as early rehabilitation, are also essential to address the complex needs of these patients and improve outcomes.