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Secondary extramedullary plasmacytoma causing small bowel intussusception in a patient with multiple myeloma - A case report.
Int J Surg Case Rep. 2013; 4(5):486-8.IJ

Abstract

INTRODUCTION

Multiple myeloma is a monoclonal, immunoproliferative plasma-cell neoplasm of the B lymphoid cells. Extramedullary plasmacytoma is a type of plasma-cell neoplasm that can present as a primary tumour or secondary to another plasma-cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease with ileum involvement being very rare.

PRESENTATION OF CASE

We report a rare case of a 58-year-old man, with known multiple myeloma, re-presenting with evidence of small bowel obstruction, secondary to an intussusception due to a malignant plasma cell deposit, which was successfully resected at laparotomy. Previous two similar admissions, prior to this index admission, failed to arrive at this difficult rare diagnosis.

DISCUSSION

Primary and secondary extramedullary plasmacytoma mainly affects the upper aero-digestive tract. Involvement of the ileum, as in this case, is a rare complication. Prognosis of secondary extramedullary plasmacytoma affecting the gastrointestinal tracts is unknown, due to the small number of cases reported in the literature, but suggestive of a poor prognosis. The role of surgery is often palliative to deal with resolvable life-threatening emergencies and where possible to prolong life.

CONCLUSION

The case adds to the current literature of the rare event of visceral secondary extramedullary plasmacytoma involving the gastrointestinal tract, in the course of multiple myeloma and highlights the need for a high index of suspicion for such uncommon complications, to avoid delay in diagnosis and treatment.

Authors+Show Affiliations

Gastroenterology, Surgery & Renal Services Directorate, Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth PL6 8DH, United Kingdom.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23562898

Citation

Ariyarathenam, Arun, et al. "Secondary Extramedullary Plasmacytoma Causing Small Bowel Intussusception in a Patient With Multiple Myeloma - a Case Report." International Journal of Surgery Case Reports, vol. 4, no. 5, 2013, pp. 486-8.
Ariyarathenam A, Galvin N, Akoh JA. Secondary extramedullary plasmacytoma causing small bowel intussusception in a patient with multiple myeloma - A case report. Int J Surg Case Rep. 2013;4(5):486-8.
Ariyarathenam, A., Galvin, N., & Akoh, J. A. (2013). Secondary extramedullary plasmacytoma causing small bowel intussusception in a patient with multiple myeloma - A case report. International Journal of Surgery Case Reports, 4(5), 486-8. https://doi.org/10.1016/j.ijscr.2013.02.018
Ariyarathenam A, Galvin N, Akoh JA. Secondary Extramedullary Plasmacytoma Causing Small Bowel Intussusception in a Patient With Multiple Myeloma - a Case Report. Int J Surg Case Rep. 2013;4(5):486-8. PubMed PMID: 23562898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Secondary extramedullary plasmacytoma causing small bowel intussusception in a patient with multiple myeloma - A case report. AU - Ariyarathenam,Arun, AU - Galvin,Nick, AU - Akoh,Jacob A, Y1 - 2013/03/14/ PY - 2012/10/28/received PY - 2013/02/17/revised PY - 2013/02/21/accepted PY - 2013/4/9/entrez PY - 2013/4/9/pubmed PY - 2013/4/9/medline SP - 486 EP - 8 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 4 IS - 5 N2 - INTRODUCTION: Multiple myeloma is a monoclonal, immunoproliferative plasma-cell neoplasm of the B lymphoid cells. Extramedullary plasmacytoma is a type of plasma-cell neoplasm that can present as a primary tumour or secondary to another plasma-cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease with ileum involvement being very rare. PRESENTATION OF CASE: We report a rare case of a 58-year-old man, with known multiple myeloma, re-presenting with evidence of small bowel obstruction, secondary to an intussusception due to a malignant plasma cell deposit, which was successfully resected at laparotomy. Previous two similar admissions, prior to this index admission, failed to arrive at this difficult rare diagnosis. DISCUSSION: Primary and secondary extramedullary plasmacytoma mainly affects the upper aero-digestive tract. Involvement of the ileum, as in this case, is a rare complication. Prognosis of secondary extramedullary plasmacytoma affecting the gastrointestinal tracts is unknown, due to the small number of cases reported in the literature, but suggestive of a poor prognosis. The role of surgery is often palliative to deal with resolvable life-threatening emergencies and where possible to prolong life. CONCLUSION: The case adds to the current literature of the rare event of visceral secondary extramedullary plasmacytoma involving the gastrointestinal tract, in the course of multiple myeloma and highlights the need for a high index of suspicion for such uncommon complications, to avoid delay in diagnosis and treatment. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/23562898/Secondary_extramedullary_plasmacytoma_causing_small_bowel_intussusception_in_a_patient_with_multiple_myeloma___A_case_report_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(13)00071-0 DB - PRIME DP - Unbound Medicine ER -
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