Comba Isin Y, Torres Luna Nancy E, Cooper Christopher, W Crespo Maria, Carilli Allison
Internal Medicine, University of Central Florida College of Medicine, Orlando, USA.
Pathology, Osceola Regional Medical Center, Kissimmee, USA.
Cureus. 2019 Jan 31;11(1):e3993. doi: 10.7759/cureus.3993.
Gastrointestinal (GI) involvement by multiple myeloma is a rare entity. Clinical manifestations depend on the site and extent of involvement. GI bleeding, obstruction, and perforation can complicate the disease course. We report a rare case of an extramedullary plasmacytoma ulcerating through the gastric mucosa and presenting as a massive upper GI bleed, which was controlled surgically with en-bloc resection of the mass infiltrating the stomach, distal pancreas, and spleen. To our knowledge, this is the first case of immunoglobulin A (IgA) myeloma with multiple GI organ involvement presenting with massive upper GI bleeding.
多发性骨髓瘤累及胃肠道是一种罕见的情况。临床表现取决于受累的部位和范围。胃肠道出血、梗阻和穿孔会使疾病进程复杂化。我们报告了一例罕见病例，即髓外浆细胞瘤穿透胃黏膜形成溃疡，并表现为大量上消化道出血，通过手术整块切除浸润胃、胰腺远端和脾脏的肿块得以控制。据我们所知，这是首例累及多个胃肠道器官并伴有大量上消化道出血的免疫球蛋白A（IgA）骨髓瘤病例。
