| Summary points: | A 66-year-old presents with 2-week history of severe low-back pain radiating to the legs, nausea, retching, and mild dyspnoea, and a mediastinal mass on computed tomography and magnetic resonance imaging. This case describes the findings from laboratory and radiological examinations, biopsy, and cytogenetic analysis, the diagnosis, and treatment, and includes several images. The authors discuss review the literature on extramedullary plasmacytoma. |