Abstract
IntroductionThough uncommon, extramedullary plasmacytoma of the pancreas should be considered in the differential diagnosis of obstructive jaundice and pancreatic neoplasms. This report highlights a case of obstructive jaundice in a 46-year-old West Indian man that resulted from an extramedullary plasmacytoma.Case presentationA 46-year-old West Indian man presented to our hospital with evidence of a significant upper gastrointestinal bleed. He gave a recent history of jaundice, constitutional symptoms and back pain. Ultrasonography revealed a mass in the head of the pancreas with resultant common bile duct dilatation. The patient required urgent surgical intervention for ongoing bleeding at which time a biopsy of the pancreas was taken. Histological analysis revealed a plasmacytoma of the pancreas. A blood film showing rouleaux formation and a skeletal survey demonstrating multiple lytic lesions confirmed multiple myeloma. Before further evaluation or treatment was carried out, the patient defaulted from follow-up and died from his illness seven months later.ConclusionThis case represents an example of multiple myeloma with visceral involvement, brought to clinical attention through involvement of the pancreas. The report serves to reaffirm knowledge of the various presentations, the optimal diagnostic tools and the current proposed treatment strategies for extramedullary plasmacytomas of the pancreas.
Highlights
Introduction: Though uncommon, extramedullary plasmacytoma of the pancreas should be considered in the differential diagnosis of obstructive jaundice and pancreatic neoplasms
This report highlights a case of obstructive jaundice in a 46-year-old West Indian man that resulted from an extramedullary plasmacytoma
Extramedullary plasmacytoma represents an uncommon variant of plasma cell tumors involving organs outside the bone marrow
Summary
Extramedullary plasmacytoma represents an uncommon variant of plasma cell tumors involving organs outside the bone marrow. Journal of Medical Case Reports 2009, 3:8785 http://jmedicalcasereports.com/jmedicalcasereports/article/view/8785 intermittent passage of blood from the rectum. This was associated with coffee-ground vomitus and symptoms of anemia. He gave a past history of peptic ulcer disease. Our patient’s condition became complicated by persistent bleeding from the rectum and a resultant fall in his hemoglobin level to 4.4 g/dL over a 2-day period. Though he remained hemodynamically normal, limited blood availability, continued bleeding and the unavailability of endoscopy prompted a decision to proceed to laparotomy.
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