title: Extramedullary relapse of multiple myeloma presenting as hematemesis and melena.
abstract: 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.
authors.affiliation: Department of Haematology and Bone Marrow Transplantation, The Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria 3181, Australia. dawsonm@ausdoctors.net
authors.forename: Mark A
authors.initials: MA
authors.lastname: Dawson
authors.forename: Mark N
authors.initials: MN
authors.lastname: Polizzotto
authors.forename: Adam
authors.initials: A
authors.lastname: Gordon
authors.forename: Stuart K
authors.initials: SK
authors.lastname: Roberts
authors.forename: Andrew
authors.initials: A
authors.lastname: Spencer
mesh_terms: 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