Secondary extramedullary plasmacytoma of sigmoid colon in a patient with multiple myeloma: a case report

Abstract

BackgroundExtramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to another plasma cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease. Involvement of the gastrointestinal tract occurs in approximately 10% of cases.Case presentationA 71-year-old Caucasian woman with known diverticular disease of the colon and multiple myeloma diagnosed 3 years previously, with monoclonal bands of immunoglobulin A, lambda light chains, and multiple osteolytic lesions, presented to our hospital with abdominal pain, abdominal discomfort, and pneumoperitoneum. She underwent left colectomy for diverticulitis with perforation, and an extramedullary secondary colonic plasmacytoma was found in histopathological examination of the sigmoid colon.ConclusionsPlasmacytoma is known to occur in extraosseous sites. The stomach and small intestine are the most commonly involved sites in the gastrointestinal tract. Secondary extramedullary plasmacytoma of the colon is rare. Colonic plasmacytoma may have varying clinical presentations, such as inflammatory bowel disease and multiple colonic strictures. Although these cases are rare, treating physicians as well as radiologists, pathologists, and surgeons should be aware of this entity.

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

“…EMP can be divided into two types: Primary and secondary. EMP can also present as a secondary tumor of another plasma cell neoplasm, such as MM[ 15 ]. MM must be excluded before the diagnosis of primary EMP[ 16 ].…”

<p>Lower Gastrointestinal Involvement in Multiple Myeloma: A Case Report</p>

“…Extramedullary plasmacytoma occurs in around 3-20% of plasmacytomas in various studies, and involvement of the colon is rare. 1,8 It is commonly seen in upper respiratory tract (82%) with the rest in the urinary bladder, brain, thyroid, skin, etc. Involvement of GI tract is seen in less than 10% of cases, frequent in the small intestinal tract, followed by the stomach colon and esophagus.…”

“…Studies have shown surgical intervention has good outcomes, and radiation therapy is used if surgery is not indicated. 1 The use of adjuvant chemotherapy is recommended for patients with higher-grade disease, tumor size >5 cm, or refractory disease. The prognosis of GI involvement is unknown; however, studies have indicated a poor prognosis.…”

“…The prognosis of GI involvement is unknown; however, studies have indicated a poor prognosis. 1,8,9 Multiple myeloma is a systemic disease affecting multiple organ systems with varying atypical presentations. Presence of GI bleeding with inconclusive endoscopic and imaging studies may be related to hematopoietic malignancies which should be addressed further.…”

“…Extramedullary plasmacytoma can occur in the presence of another plasma cell malignancy such as MM. 1 Neoplastic proliferation of plasma cells in the bone marrow resulting in extensive bone destruction with systemic features suggestive of malignancy is characteristic for MM. 2 Occasionally they can infiltrate other organ systems such as the kidney causing renal impairment.…”