Case Report
An Unusual Presentation of Multiple Myeloma: Plasmacytic Ascites Complicated by Duodenal Involvement Multiple Myeloma’nın Nadir bir Prezentasyonu: Duedonal Tutulum ile Komplike olan Plazmasitik Asit
Abstract
Abstract: The incidence of gastrointestinal system involvement during the course
of multiple myeloma (MM) is rare. The usually
affected sites of GI tract are small and large bowel, stomach, and rarely
esophagus. Only a few MM cases are also known with myelomatous ascites at
presentation. In this report, we present a 67-year old patient who developed
myelomatosus ascites. Although rare, MM can involve extramedullary areas such
as duodenum and different kinds of complications may occur. In addition to
standard diagnostic and treatment methods, individualized diagnostic and
therapeutic options should be considered for such patients.
Key words: multiple myeloma, ascites, duodenal involvement
Öz: Multiple myeloma (MM) seyrinde gastrointestinal sistem tutulumu
nadirdir. Gastrointestinal sistemde sıklıkla ince ve kalın bağırsak, mide ve
nadiren de özefagus tutulur. MM vakalarında myeloma bağlı asit ile başvuran
hasta sayısı çok azdır. Bu vaka sunumunda myeloma bağlı asit gelişen 67 yaşında
bir erkek hasta sunulmuştur. Nadir görülmesine rağmen MM duodenum gibi
extramedüller bölgeleri tutabilir ve buna bağlı farklı komplikasyonlar gelişebilir.
Bu tür hastalarda standart tanı ve tedavi yöntemlerine ek olarak,
bireyselleştirilmiş tanı ve tedavi seçenekleri de düşünülmelidir.
Anahtar Kelimeler: multiple myelom,
asit, duodenal tutulum
Keywords
References
- 1.Alexiou C, Reinhardt JK, Dietzfelbinger H, et al. Extramedullary plasmacytoma: tumor occurrence andtherap eutic concepts. Cancer 1999;85:2305–14.
- 2.Goldstein WB, Parker N. Multiple myeloma involving the GI tract. Gastroenterology 1966;51:87–93.
- 3.Siddique I, Papadakis KA, Weber DM, Glober G. Recurrent bleeding from a duodenal plasmacytoma treated successfully with embolization of the gastroduodenal artery. Am J Gastroenterol. 1999 Jun;94(6):1691-2.
- 4.Alegre A, Martinez-Chamorro C, Fernandez-Ranada JM. Massive myelomatous ascites responsive to VAD chemotherapy and autologous stem cell transplantation. Bone Marrow Transplant. 1999 Aug;24(3):343-4.
- 5.Greer JP, Pinson RD, Russell WG et al. Malignant plasmacytic ascites. A report of two cases and review of the literature. Cancer 1985; 56: 2001–2004.
- 6. Karp SJ, Shareef D. Ascites as a presenting feature multiple myeloma. J R Soc Med 1987;80:182–4.
- 7.Inoue Y, Chua K, McClure RF, Jimenez MC, Gocke CD, Badros AZ, Takebe N. Multiple myeloma presenting initially as a solitary pleural effusion later complicated by malignant plasmacytic ascites. Leuk Res. 2005 Jun;29(6):715-8.
- 8.Keren D, Schliamser L, Atias D: Myeloma ascites—A favorable outcome with cyclophosphamide therapy. Am J Hematol 60:140–142, 1999.
- 9.Attwell A, Dee E, Russ P, Nash R, Shah R. Multiple myeloma involving the porta hepatis and peritoneum causing biliary obstruction and malignant ascites. Dig Dis Sci. 2005 Jun;50(6):1068-71
- 10.Hayes D, BennettW: Extramedullary lesions in multiple myeloma: review of literature and pathologic studies. Arch Pathol Lab Med 53:317–329, 1952
- 11.Pasmantier MW, Azar HA: Extraskeletal spread in multiple plasma cell myeloma: a review of 57 autopsied cases. Cancer 23:167–174, 1969
- 12.Ingegno AP. Plasmacytoma of the gastrointestinal tract: Report of a case involving the jejunum and review of the literature. Gastroenterology 1954;26:89 –102.
- 13.Kodama Y et al. (1999) MALT lymphoma simulating an extramedullary plasmacytoma of the stomach. Am J Med 107: 530–532
- 14.Tada S et al. (1990) Endoscopic and biopsy findings of the upper digestive tract in patients with amyloidosis. Gastrointest Endosc 36: 10–14
- 15.Hainsworth JD et al. (1991) Poorly differentiated carcinoma of unknown primary site: clinical usefulness of immunoperoxidase staining. J Clin Oncol 9:1931–1938
- 16.Esfandyari T, Abraham SC, Arora AS. Gastrointestinal plasmacytoma that caused anemia in a patient with multiple myeloma. Nat Clin Pract Gastroenterol Hepatol. 2007 Feb;4(2):111-5.
Year 2017,
Volume: 39 Issue: 2, 60 - 64, 21.07.2017
Abstract
References
- 1.Alexiou C, Reinhardt JK, Dietzfelbinger H, et al. Extramedullary plasmacytoma: tumor occurrence andtherap eutic concepts. Cancer 1999;85:2305–14.
- 2.Goldstein WB, Parker N. Multiple myeloma involving the GI tract. Gastroenterology 1966;51:87–93.
- 3.Siddique I, Papadakis KA, Weber DM, Glober G. Recurrent bleeding from a duodenal plasmacytoma treated successfully with embolization of the gastroduodenal artery. Am J Gastroenterol. 1999 Jun;94(6):1691-2.
- 4.Alegre A, Martinez-Chamorro C, Fernandez-Ranada JM. Massive myelomatous ascites responsive to VAD chemotherapy and autologous stem cell transplantation. Bone Marrow Transplant. 1999 Aug;24(3):343-4.
- 5.Greer JP, Pinson RD, Russell WG et al. Malignant plasmacytic ascites. A report of two cases and review of the literature. Cancer 1985; 56: 2001–2004.
- 6. Karp SJ, Shareef D. Ascites as a presenting feature multiple myeloma. J R Soc Med 1987;80:182–4.
- 7.Inoue Y, Chua K, McClure RF, Jimenez MC, Gocke CD, Badros AZ, Takebe N. Multiple myeloma presenting initially as a solitary pleural effusion later complicated by malignant plasmacytic ascites. Leuk Res. 2005 Jun;29(6):715-8.
- 8.Keren D, Schliamser L, Atias D: Myeloma ascites—A favorable outcome with cyclophosphamide therapy. Am J Hematol 60:140–142, 1999.
- 9.Attwell A, Dee E, Russ P, Nash R, Shah R. Multiple myeloma involving the porta hepatis and peritoneum causing biliary obstruction and malignant ascites. Dig Dis Sci. 2005 Jun;50(6):1068-71
- 10.Hayes D, BennettW: Extramedullary lesions in multiple myeloma: review of literature and pathologic studies. Arch Pathol Lab Med 53:317–329, 1952
- 11.Pasmantier MW, Azar HA: Extraskeletal spread in multiple plasma cell myeloma: a review of 57 autopsied cases. Cancer 23:167–174, 1969
- 12.Ingegno AP. Plasmacytoma of the gastrointestinal tract: Report of a case involving the jejunum and review of the literature. Gastroenterology 1954;26:89 –102.
- 13.Kodama Y et al. (1999) MALT lymphoma simulating an extramedullary plasmacytoma of the stomach. Am J Med 107: 530–532
- 14.Tada S et al. (1990) Endoscopic and biopsy findings of the upper digestive tract in patients with amyloidosis. Gastrointest Endosc 36: 10–14
- 15.Hainsworth JD et al. (1991) Poorly differentiated carcinoma of unknown primary site: clinical usefulness of immunoperoxidase staining. J Clin Oncol 9:1931–1938
- 16.Esfandyari T, Abraham SC, Arora AS. Gastrointestinal plasmacytoma that caused anemia in a patient with multiple myeloma. Nat Clin Pract Gastroenterol Hepatol. 2007 Feb;4(2):111-5.
There are 16 citations in total.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | OLGU SUNUMU |
| Authors | |
| Publication Date | July 21, 2017 |
| Published in Issue | Year 2017 Volume: 39 Issue: 2 |