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Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature
BACKGROUND: Plasma-cell neoplasms rarely involve the gastrointestinal tract and manifest as gastrointestinal bleeding. Plasmablastic myeloma is an aggressive plasma cell neoplasm associated with poor outcomes. A small number of cases with gastrointestinal involvement is reported in the literature an...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475702/ https://www.ncbi.nlm.nih.gov/pubmed/31040892 http://dx.doi.org/10.4253/wjge.v11.i4.308 |
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author | Iosif, Evangelia Rees, Clare Beeslaar, Salome Shamali, Awad Lauro, Roberto Kyriakides, Charis |
author_facet | Iosif, Evangelia Rees, Clare Beeslaar, Salome Shamali, Awad Lauro, Roberto Kyriakides, Charis |
author_sort | Iosif, Evangelia |
collection | PubMed |
description | BACKGROUND: Plasma-cell neoplasms rarely involve the gastrointestinal tract and manifest as gastrointestinal bleeding. Plasmablastic myeloma is an aggressive plasma cell neoplasm associated with poor outcomes. A small number of cases with gastrointestinal involvement is reported in the literature and therefore high index of suspicion is essential for avoiding delays in diagnosis and treatment. CASE SUMMARY: Our aim is to present our experience of a 70-year-old patient with a secondary presentation of plasmablastic myeloma manifesting as unstable upper gastrointestinal bleeding and to review the literature with the view to consolidate and discuss information about diagnosis and management of this rare entity. In addition to our case, a literature search (PubMed database) of case reports of extramedullary plasma cell neoplasms manifesting as upper gastrointestinal bleeding was performed. Twenty-seven cases of extramedullary plasmacytoma (EMP) involving the stomach and small bowel presenting with upper gastrointestinal bleeding were retrieved. The majority of patients were males (67%). The average age on diagnosis was 62.7 years. The most common site of presentation was the stomach (41%), followed by the duodenum (15%). The most common presenting complaint was melena (44%). In the majority of cases, the EMPs were a secondary manifestation (63%) at the background of multiple myeloma (26%), plasmablastic myeloma (7%) or high-grade plasma cell myeloma (4%). Oesophagogastroscopy was the main diagnostic modality and chemotherapy the preferred treatment option for secondary EMPs. CONCLUSION: Despite their rare presentation, upper gastrointestinal EMPs should be considered in the differential diagnosis of patients with gastrointestinal bleeding especially in the presence of systemic haematological malignancy. |
format | Online Article Text |
id | pubmed-6475702 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-64757022019-04-30 Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature Iosif, Evangelia Rees, Clare Beeslaar, Salome Shamali, Awad Lauro, Roberto Kyriakides, Charis World J Gastrointest Endosc Case Report BACKGROUND: Plasma-cell neoplasms rarely involve the gastrointestinal tract and manifest as gastrointestinal bleeding. Plasmablastic myeloma is an aggressive plasma cell neoplasm associated with poor outcomes. A small number of cases with gastrointestinal involvement is reported in the literature and therefore high index of suspicion is essential for avoiding delays in diagnosis and treatment. CASE SUMMARY: Our aim is to present our experience of a 70-year-old patient with a secondary presentation of plasmablastic myeloma manifesting as unstable upper gastrointestinal bleeding and to review the literature with the view to consolidate and discuss information about diagnosis and management of this rare entity. In addition to our case, a literature search (PubMed database) of case reports of extramedullary plasma cell neoplasms manifesting as upper gastrointestinal bleeding was performed. Twenty-seven cases of extramedullary plasmacytoma (EMP) involving the stomach and small bowel presenting with upper gastrointestinal bleeding were retrieved. The majority of patients were males (67%). The average age on diagnosis was 62.7 years. The most common site of presentation was the stomach (41%), followed by the duodenum (15%). The most common presenting complaint was melena (44%). In the majority of cases, the EMPs were a secondary manifestation (63%) at the background of multiple myeloma (26%), plasmablastic myeloma (7%) or high-grade plasma cell myeloma (4%). Oesophagogastroscopy was the main diagnostic modality and chemotherapy the preferred treatment option for secondary EMPs. CONCLUSION: Despite their rare presentation, upper gastrointestinal EMPs should be considered in the differential diagnosis of patients with gastrointestinal bleeding especially in the presence of systemic haematological malignancy. Baishideng Publishing Group Inc 2019-04-16 2019-04-16 /pmc/articles/PMC6475702/ /pubmed/31040892 http://dx.doi.org/10.4253/wjge.v11.i4.308 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Case Report Iosif, Evangelia Rees, Clare Beeslaar, Salome Shamali, Awad Lauro, Roberto Kyriakides, Charis Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature |
title | Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature |
title_full | Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature |
title_fullStr | Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature |
title_full_unstemmed | Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature |
title_short | Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature |
title_sort | gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: a case report and review of the literature |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475702/ https://www.ncbi.nlm.nih.gov/pubmed/31040892 http://dx.doi.org/10.4253/wjge.v11.i4.308 |
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