Extramedullary relapse of multiple myeloma presenting as hematemesis and melena.
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.


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


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


RESULTS
High-dose infusion of omeprazole, blood product support, palliative analgesics and anxiolytic agents.
Dawson
Mark A
MA
Department of Haematology and Bone Marrow Transplantation, The Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria 3181, Australia. dawsonm@ausdoctors.net
Polizzotto
Mark N
MN
Gordon
Adam
A
Roberts
Stuart K
SK
Spencer
Andrew
A
D003937:Diagnosis, Differential; D005260:Female; D006396:Hematemesis / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008551:Melena / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D012008:Recurrence; D033581:Stem Cell Transplantation