Plasmacytoma is a systemic malignancy and it is the most frequent primary tumor affecting the skeleton. Progression from solitary plasmacytoma to systemic diffusion is reported to be 65-100% in 15 years. A case report of a rare 22-year follow-up of a thoracic solitary plasmacytoma is here presented. Clinical case analysis, radiographs, magnetic resonance images and histological sections of the lesion are discussed. Repeated surgical interventions were required due to progression and local

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... ence of disease. Although the inadequate surgical treatment, low response to chemotherapy and radiation therapy, and many local recurrences, no systemic diffusion of the disease was observed in 22 years. Aggressive surgery may be indicated in young patients with isolated lesion and good prognostic factors. Palliative surgery remains necessary in order to decompress the cord and to stabilize the spine.