The Detection of Pancreatic and Retroperitoneal Plasmacytoma Helped to Diagnose Multiple Myeloma

Abstract

Multiple myeloma is characterized by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal protein. However, the involvement of pancreas is a rare event. We herein report a rare case of pancreatic plasmacytoma, which was detected before the diagnosis of multiple myeloma.An 83-year-old male was referred to our hospital for further evaluation of obstructive jaundice and a pancreatic mass. A contrast-enhanced computed tomography (CT) scan revealed solid masses with homogenous enhancement in the pancreatic head and retroperitoneum. The histological findings of the retroperitoneal mass obtained by CT-guided biopsy showed multiple sheets of atypical plasma cells, which were positively immunostained for CD79a, CD138, and the κ light chain. Serum immunoelectrophoresis detected M-component of immunoglobulin A-κ, and the histological findings of the bone marrow revealed an abnormally increased number of atypical plasma cells with irregular nuclei and cytoplasmic vacuolation. The patient was therefore diagnosed to have multiple myeloma involving the pancreas and retroperitoneum. Although chemotherapy was performed, the patient died 6 months after the diagnosis.The pancreatic plasmacytoma was detected before the multiple myeloma in the present case. It is difficult to diagnose a pancreatic plasmacytoma without a history of multiple myeloma and related disease.

Solitary plasmacytoma of the pancreas: A rare case report

“…Commonly established CT characteristics are described as a well-defined, focal, multilobulated solid mass with homogeneous IV contrast enhancement and hypodense in relation to the pancreatic parenchyma [2] . These generally nonspecific radiological features make pancreatic plasmacytomas challenging to differentiate from other pancreatic tumors that show IV contrast enhancement, such as PNETs and adenocarcinomas, especially in patients without a history of MM and related disease [9] . Lesion enhancement is another common feature of pancreatic plasmacytomas rendering differentiation from PNETs difficult [10] .…”

Multiple myeloma with onset of pancreas involvement

“…[11] Reasons of death are mostly infections during chemotherapy treatment [9,10] and only 1 patient died of systemic failure. [15]…”

A Case of Concurrent Gastric and Pancreatic Plasmacytomas in a Patient With Multiple Myeloma: An Extremely Rare Entity

“…Most patients presented with features of obstructive jaundice, and one case was diagnosed during autopsy. 4 , 18 - 30 …”