Recurrent Radiculopathy Caused by an Epidural Cervical Plasmacytoma Revealing Plasma Cell Leukemia: A Case Report and Literature Review.

Cervical radiculopathy in elderly patients is commonly associated with degenerative spine disease, which can make the diagnosis of less frequent epidural tumors challenging. Epidural cervical plasmacytoma is rare and may initially present with neck pain and radicular symptoms that closely resemble cervical spondylosis. We report the case of a 76-year-old woman with axial neck pain and left upper extremity radiculopathy initially managed as degenerative cervical disease, with temporary postoperative improvement followed by recurrence of symptoms. Further surgical evaluation revealed an epidural cervical mass involving the lower cervical nerve roots, and histopathological analysis confirmed plasmacytoma. Subsequent hematologic assessment established the diagnosis of plasma cell leukemia. This case highlights the importance of maintaining a broad differential diagnosis in patients with recurrent, progressive, or atypical radicular symptoms, especially when the clinical course is not fully explained by degenerative pathology. Early tissue diagnosis and systemic evaluation are essential to guide appropriate multidisciplinary treatment.