Extramedullary relapse of multiple myeloma presenting as hematemesis and melena.

作者信息

Dawson Mark A, Polizzotto Mark N, Gordon Adam, Roberts Stuart K, Spencer Andrew

机构信息

Department of Haematology and Bone Marrow Transplantation, The Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria 3181, Australia.

出版信息

Nat Clin Pract Oncol. 2006 Apr;3(4):223-6; quiz 227. doi: 10.1038/ncponc0454.

BACKGROUND

A 60-year-old woman with multiple myeloma relapsed after a good partial response to high-dose chemotherapy (melphalan 200 mg/m(2)) and autologous stem-cell transplantation, followed by thalidomide and prednisolone maintenance therapy. She presented with hematemesis and melena following salvage chemotherapy with dexamethasone, cyclophosphamide, etoposide, cisplatin, and rescue therapy with single-agent bortezomib.

INVESTIGATIONS

Physical examination, laboratory investigations, gastroscopy, 2-[(18)F]fluoro-2-deoxyglucose-PET (FDG-PET), breast biopsy and histology.

DIAGNOSIS

Multifocal extramedullary relapse of multiple myeloma involving the stomach and duodenum.

MANAGEMENT

High-dose infusion of omeprazole, blood product support, palliative analgesics and anxiolytic agents.