Year 2022 / Volume 114 / Number 10
Letter
Extramedullary plasmacytoma with colonic involvement: experience in a tertiary hospital

629-630

DOI: 10.17235/reed.2022.8828/2022

María José Mesa López, Alejandro Salazar Nicolás, Juan Diego Leal Rubio, María Muñoz Tornero, Juan Egea Valenzuela,

Abstract
A 71-year-old woman diagnosed with type II diabetes mellitus with severe iron deficiency anemia and positive fecal occult blood. Colonoscopy was performed, showing a soft mass in the ascending colon, with biopsies compatible with plasmacytoma and restriction for Kappa light chains. After bone marrow aspiration, associated IgG multiple myeloma was detected, so chemotherapy with VMP (bortezomib, melphalan and prednisone) was started. Colonoscopy six months later showed that the ulcerated lesion had a reduction in tumor size of up to 80%. A 27-year-old male with a history of kidney transplantation and symptoms of chronic diarrhea, colonoscopy was indicated with the finding of a large exophytic and ulcerated lesion in the cecum. Pathology revealed plasmacytoma with restriction of lambda light chains. After ruling out lesions in other locations, the patient was treated with immunochemotherapy according to the Bortezomib-Rituximab-Dexamethasone scheme, with subsequent complete clinical and endoscopic remission. Plasmacytoma accounts for < 4 % of plasma cell tumours. It may appear isolated or associated with another plasma cell neoplasm, mainly multiple myeloma. Its presence in the gastrointestinal tract is rare, being infrequent in the stomach or small intestine, and even rarer in the colonic tract (incidence 1/10,000,000). The clinical manifestations are similar to those of other colon neoplasms, while the treatment or prognosis may differ from those of other neoplasms. In patients with clinical suspicion, it is important to perform an early endoscopic study, especially in patients diagnosed with multiple myeloma.
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References
Islam SR, Attaya MN, Parupudi S et al. Sigmoid plasmacytoma mimicking colon cáncer in a patient with multiple myeloma: case report and review of literature. Gastrointest Endosc 2010; 71: 655–657
Nakagawa Y, Nagai T, Okawara H, et al. Minute primary extramedullary plasmacytomas of the large intestine. Endoscopy. 2011;43(2):E105–6.
Ottaiano A, Santorsola M, Perri F, Pace U, Marra B, Correra M, Sabbatino F, Cascella M, Petrillo N, Ianniello M, Casillo M, Misso G, Delrio P, Caraglia M, Nasti G. Clinical and Molecular Characteristics of Rare Malignant Tumors of Colon and Rectum. Biology (Basel). 2022 Feb 8;11(2):267.
Busta Nistal MR, Del Olmo Martínez ML, Corrales Cruz D, Durà Gil M. Gastric plasmacytoma: a rare cause of upper gastrointestinal bleeding. Rev Esp Enferm Dig. 2021 Jul;113(7):543-544.
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Citation tools
Mesa López M, Salazar Nicolás A, Leal Rubio J, Muñoz Tornero M, Egea Valenzuela J. Extramedullary plasmacytoma with colonic involvement: experience in a tertiary hospital. 8828/2022


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Publication history

Received: 30/03/2022

Accepted: 01/04/2022

Online First: 26/04/2022

Published: 07/10/2022

Article Online First time: 27 days

Article editing time: 191 days


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