A Rare Case of Small Bowel Extramedullary Plasmacytomas Presenting With Intestinal Obstruction

Alnimer, Lynna; Zakaria, Ali; Al-Share, Bayan; Samhouri, Yazan; Raphael, Michael J.

doi:10.7759/cureus.15704

Cited by 3 publications

(7 citation statements)

References 16 publications

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“…[ 2 , 11 ] Their clinical presentations varied, since symptoms are related to the effect of the mass on the surrounding structures. [ 2 , 12 ] Possible symptoms are abdominal pain, intestinal obstruction, intussusception, nausea, vomiting, constipation, weight loss, malabsorption, GI bleeding, and obstructive jaundice. [ 2 ] Our female patient also had EMP of the ileum, which is a primary type, although she had a past history of lymphoma 22 years ago.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike our case, Alnimer et al reported a case of multiple EMPs of the ileum in a 51-year-old woman who presented with small bowel obstruction and had a previous history of solitary plasmacytoma of the left acetabulum. [ 12 ] They described that their case developed multiple EMPs of the ileum 3 years after the diagnosis of SPB. [ 12 ] By contrast, our male patient developed metastasis in the left posterior epidural space of T 8–10 spine due to late diagnosis of EMP.…”

Section: Discussionmentioning

confidence: 99%

“…[ 12 ] They described that their case developed multiple EMPs of the ileum 3 years after the diagnosis of SPB. [ 12 ] By contrast, our male patient developed metastasis in the left posterior epidural space of T 8–10 spine due to late diagnosis of EMP. He was surgically diagnosed 1 year after experiencing melena symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Two cases of extramedullary plasmacytoma of the small intestine presenting with ileus: A case report

Park¹,

Kwon²,

Jeong³

et al. 2022

Medicine

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Background: Extramedullary (extraosseous) plasmacytoma (EMP) of the small intestine is a rare plasma cell neoplasm (PCN) that presents with abdominal pain, nausea, vomiting, etc. We describe 2 cases of EMP of the small intestine that presented with ileus. Methods: A 78-year-old woman and 68-year-old man visited our clinic with complaints of abdominal discomfort and obstruction. Abdominal computed tomography (CT) revealed a thickened lesion with multiple enlarged mesenteric lymph nodes (LNs) in the ileum and duodenum. The female patient underwent segmental resection in the ileum. The male patient underwent Whipple’s operation in the duodenum. Results: Histopathological examination and immunohistochemical staining of resected specimens from the 2 patients confirmed a PCN. In the surgical specimens of 2 cases, immunoglobulin heavy-chain rearrangement was confirmed by polymerase chain reaction amplification, but no Epstein-Barr virus (EBV)-infected cells were found by EBV-in situ hybridization. Bone marrow aspirate and trephine biopsies were negative for the type of PCN. Bone marrow cytogenetics and fluorescence in situ hybridization revealed no abnormalities. Serum β2-microglobulin levels were within normal limits. Additionally, none of the patients showed an M-spike in serum or urine protein electrophoresis. Therefore, the patients were diagnosed with a solitary EMP of the small intestine. The female patient refused treatment. At follow-up 3 months postoperatively, her disease progressed and she newly developed multiple LNs and nodular lesions in the right pelvic side wall. She was treated with dexamethasone. The male patient experienced back pain 25 days after Whipple’s operation. Spine series magnetic resonance imaging revealed an intermediate signal intensity mass in the posterior epidural space from T8/9 to T10. The mass was removed, and the same histologic features were identified as duodenal masses. He was treated with dexamethasone and radiotherapy. Conclusions: EMPs of the small intestine are easy to overlook because they rarely occur in the small intestine. Although surgery is not required for diagnosis, surgical resection can be a good option for EMPs of the small intestine, instead of local radiation therapy. However, close follow-up is required due to the possibility of relapse or progression to plasma cell myeloma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Two cases of extramedullary plasmacytoma of the small intestine presenting with ileus: A case report

Park¹,

Kwon²,

Jeong³

et al. 2022

Medicine

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“…They most commonly arise from the head, neck, and upper respiratory tract. Solitary gastrointestinal (GI) plasmacytomas are even more unique, accounting for approximately 4% of extramedullary plasmacytomas [ 3 ]. Presenting symptoms depend on the location of the mass with abdominal pain, fatigue, GI bleeds, and altered bowel habits being the most reported for GI plasmacytomas in the literature [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Primary Duodenal Plasmacytoma: An Incidental Finding

Mohamed¹,

Haji²,

Hassan³

et al. 2023

Cureus

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Solitary extramedullary plasmacytoma (SEP) is a rare tumor due to the monoclonal proliferation of plasma cells without bone marrow involvement. Plasmacytomas are frequently encountered in bone or soft tissue but rarely occur in the gastrointestinal (GI) tract. They can present with a multitude of symptoms depending on their site. This report describes a case of SEP diagnosed as a duodenal ulcer (DU) during esophagogastroduodenoscopy (EGD) for iron deficiency anemia.

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“…Clinical manifestations of gastrointestinal EMPs vary with the location and progression of the tumor and lack specificity. Common clinical manifestations include abdominal pain, abdominal discomfort, changes in bowel habits, gastrointestinal bleeding and intestinal obstruction[ 8 - 12 ]. However, there are no reports of spontaneous perforation and abdominal abscess caused by EMP of the small intestine.…”

Section: Introductionmentioning

confidence: 99%

Intestinal perforation with abdominal abscess caused by extramedullary plasmacytoma of small intestine: A case report and literature review

Wang¹,

Xiao²

2022

WJGS

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BACKGROUND Extramedullary plasmacytoma (EMP) of the gastrointestinal tract is an extremely rare disease. Clinical manifestations of EMPs are varied and depend on the location and progression of the tumor. CASE SUMMARY Here, we firstly report a case of intestinal perforation with abdominal abscess caused by EMP of the small intestine in a 55-year-old female patient. The patient received emergency surgery immediately after the necessary preoperative procedures. During the operation, EMP was found to have caused the perforation of the small intestine and the formation of multiple abscesses in the abdominal cavity. Partial resection of the small intestine with peritoneal irrigation and drainage was performed. EMP was finally confirmed by postoperative histopathology and laboratory tests. Additionally, we performed a literature review of gastrointestinal EMP to obtain a deeper understanding of this disease. CONCLUSION EMP of the small intestine may have spontaneous perforation, which requires emergency surgery. Surgical resection can obtain good therapeutic effects.

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A Rare Case of Small Bowel Extramedullary Plasmacytomas Presenting With Intestinal Obstruction

Cited by 3 publications

References 16 publications

Two cases of extramedullary plasmacytoma of the small intestine presenting with ileus: A case report

Two cases of extramedullary plasmacytoma of the small intestine presenting with ileus: A case report

A Rare Case of Primary Duodenal Plasmacytoma: An Incidental Finding

Intestinal perforation with abdominal abscess caused by extramedullary plasmacytoma of small intestine: A case report and literature review

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