Extensive Extramedullary Disease Involving the Colon in Multiple Myeloma: A Case Report and Review of Literature
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Extensive Extramedullary Disease Involving the Colon in Multiple Myeloma: A Case Report and Review of Literature Bobby R. Kakati & Kavya Krishna & Somashekar G. Krishna & Shree G. Sharma & Naveen Sanathkumar & Rayburn F. Rego
Published online: 12 August 2010 # Springer Science+Business Media, LLC 2010
Abstract Introduction Organ involvement in multiple myeloma (MM) is characterized by infiltrative disease or by a myelomatous mass known as a plasmacytoma. We present a patient with MM who had extensive extramedullary involvement of the colon and a review of the literature on colon plasmacytomas. Case report A 57-year-old male with MM presented with disease relapse in 2007, workup showing biopsy confirmed left perinephric extra-medullary disease involving the adjacent colon. Positron emission-tomography (PET) exhibited intense pan-colonic fluoro-deoxyglucose (FDG) uptake and computed-tomography confirmed extensive
B. R. Kakati : K. Krishna Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #567, Little Rock, AR 72205, USA S. G. Krishna : R. F. Rego (*) Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #567, Little Rock, AR 72205, USA e-mail: [email protected] S. G. Sharma Department of Pathology, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #567, Little Rock, AR 72205, USA N. Sanathkumar Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #567, Little Rock, AR 72205, USA
infiltrating soft tissue thickening in the ascending, transverse, and descending colon representing plasmacytomas. The patient underwent an autologous hematopoietic stem cell transplantation after conditioning with high-dose melphalan. Restaging PET-scan showed complete resolution of colonic extra-medullary plasmacytomas. Extramedullary plasmacytomas (EMP) are rare and constitute 4% of all plasma cell tumors. Discussion and Conclusion Colonic plasmacytoma is an extremely rare site, with fewer than 25 cases reported in the literature. Colonic plasmacytomas have different presentations depending on the size and location. Treatment options for primary EMPs include surgical resection, radiotherapy, and chemotherapy. The primary treatment option for secondary EMP is systemic chemotherapy. This rare pan-colonic plasmacytoma, as a part of extramedullary myeloma, showed an impressive response to chemotherapy. Keywords Multiple myeloma . Colonic plasmacytoma . Extramedullary disease
Introduction Multiple myeloma (MM) is a monoclonal plasma cell neoplasm predominately of the bone marrow that often produces great quantities of a specific immunoglobulin (Ig). Organ involvement is characterized by infiltrative disease or by a myelomatous mass known as a plasmacytoma. Plasmacytomas can result in microscopic involvement or organ deformation and dysfunction [1]. We present a patient with MM who had extensive extramedullary involv
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