The Detection of Pancreatic and Retroperitoneal Plasmacytoma Helped to Diagnose Multiple Myeloma: A Case Report

Solitary plasmacytoma of the pancreas: A rare case report

A plasmacytoma is a cancerous growth of abnormal plasma cells that arise within osseous or soft tissue structures. In soft tissue structures, plasmacytomas can present as solitary or multiple masses in the absence of systemic involvement. Solitary plasmacytomas can be subcategorized as extramedullary plasmacytoma (derived from plasma cells located in soft tissues) or osseous plasmacytoma (derived from plasma cells located in the bone marrow). Infrequently, these tumors can arise as extramedullary lesions from the pancreas and present similarly to other tumors, such as pancreatic neuroendocrine tumors (PNETs). In this article, we report the case of a 62-year-old male with a diagnosis of solitary plasmacytoma of the pancreas. We focus on optimizing diagnosis and management through the application of radiological imaging modalities, specifically computed tomography (CT) scans and positron emission tomography-computed tomography (PET-CT) scans.

Multiple myeloma with onset of pancreas involvement: A case report

RATIONALE

Multiple myeloma is the second most common hematological malignancy. Extramedullary involvement is one of the indicators of poor prognosis. There is no consensus in treatment options and the efficacy. This article reports a case of multiple myeloma with onset of pancreas involvement. Amyloidosis secondary to multiple myeloma and a partial response to the chemotherapy treatment further emphasized its rarity.

PATIENT CONCERNS

In this article, we report a 59-year-old male patient with a chief complaint of fatigue for 8 months and upper abdominal pain for 2 months.

DIAGNOSIS

The patients were diagnosed as amyloidosis secondary to multiple myeloma with pancreatic occupying (head-neck junction area) lesion based on laboratory examination and pathology from lymph node puncture and skin biopsy.

INTERVENTIONS

An intensive chemotherapy treatment as bortezomib, lenalidomide, dexamethasone, cisplatin, epirubicin, cyclophosphamide, and etoposide was given. Due to intolerance, treatment regimen was further adjusted to bortezomib, lenalidomide, and dexamethasone.

OUTCOMES

The patient was 12 months alive. After 4 cycles of chemotherapy, a partial response was achieved and abdominal magnetic resonance imaging suggested a reduced pancreatic occupying lesion.

LESSONS

This case demonstrates that pancreatic involvement, digestive system neoplasm, and amyloidosis-related clinical features may be the earliest manifestations of multiple myeloma. For these patients, an intensive chemotherapy regimen may be a possible treatment approach.

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

Multiple myeloma (MM), a plasma cell tumor, is primarily a disease of the bone marrow. Extramedullary plasmacytoma, also a plasma cell tumor, is very rare in the gastrointestinal tract and the pancreas, and only a handful cases have been documented till now. Gastric and pancreatic plasmacytomas are usually seen in elderly patients; however, cases in patients as young as 32 years of age have been reported. Commonly, patients with gastric plasmacytoma present with nonspecific symptoms like epigastric pain, abdominal fullness, anorexia, and weight loss, or serious conditions like massive upper gastrointestinal bleeding and gastric outlet obstruction. Patients with pancreatic plasmacytoma commonly present with obstructive jaundice. In this article, we present the case of a 79-year-old man with a history of MM for 3 years, diagnosed with gastric and pancreatic masses, which turned out to be plasmacytomas. To our knowledge, simultaneous occurrence of gastric and pancreatic plasmacytomas is extremely uncommon with less than 5 cases reported in the literature. We also compiled all the individual cases of gastric and pancreatic MM that have been reported in literature till now.