Boyapati Nikitha, Trivedi Anand
Acute Surgical Unit, Fiona Stanley Hospital, Murdoch, WA, Australia.
J Surg Case Rep. 2023 May 22;2023(5):rjad268. doi: 10.1093/jscr/rjad268. eCollection 2023 May.
A 75-year-old woman with a history of multiple myeloma in remission presented with signs, symptoms and imaging findings consistent with a small bowel obstruction secondary to an intussusception. She underwent operative management, and intraoperative findings were consistent with an intussusception of mid small bowel as the cause of the small bowel obstruction. The offending portion of small bowel was resected, and histopathology confirmed a plasmacytoma deposit in the small bowel at the lead point of the intussusception. Secondary extramedullary plasmacytomas in the gastrointestinal system are rare but can have significant consequences like small bowel obstruction requiring operative management. We present a rare case that emphasizes the need to be highly suspicious for uncommon sequelae of multiple myeloma like secondary extramedullary plasmacytomas when managing patients with history of multiple myeloma in remission with concerning abdominal symptoms.
一名75岁的女性，有缓解期多发性骨髓瘤病史，出现了与肠套叠继发小肠梗阻相符的体征、症状及影像学表现。她接受了手术治疗，术中发现与小肠中段肠套叠导致小肠梗阻相符。切除了发生病变的小肠部分，组织病理学证实肠套叠起始部位的小肠中有浆细胞瘤沉积物。胃肠道系统中的继发性髓外浆细胞瘤很少见，但可产生严重后果，如需要手术治疗的小肠梗阻。我们报告了一例罕见病例，强调在管理有缓解期多发性骨髓瘤病史且伴有可疑腹部症状的患者时，对于多发性骨髓瘤的罕见后遗症如继发性髓外浆细胞瘤需高度怀疑。
