Solitary myeloma of the spine.

Abstract

Plasma cell myeloma of bone may present initially with multiple lesions or with an apparently solitary lesion. Multiple myeloma runs its natural course in a period varying from a few months to an average of two years after diagnosis (Christopherson and Miller 1950), with fatal termination regardless of treatment. Solitary myelomas are unpredictable in their behaviour; they may remain localised for several years or they may disseminate. In 1923 Shaw reported the first acceptable case of solitary myeloma, and since then a number of cases have appeared in the medical literature, though the majority lack sufficient detail to support the diagnosis. As yet, there is no agreement among pathologists as to whether the so-called “ solitary myeloma “ should be considered as a form of myelomatosis or as an unrelated benign lesion (Johnson and Meador 1951). Willis (1941) and Raven and Willis (1949) were satisfied that solitary myeloma of bone is an entity distinct from multiple myelomatosis, but they stressed that a myeloma can only be accepted as a truly solitary lesion if the radiographic examination of the skeleton fails to reveal other deposits for at least one year after the original diagnosis. Using this criterion they accepted only eighteen cases, including two of their own, from the literature.