Spontaneous rupture of liver plasmacytoma mimicking hepatocellular carcinoma.
Extramedullary plasmacytoma of the liver is rare. Here, we report a case presenting with rupture of extramedullary plasmacytoma of the liver. She had a past history of multiple myeloma with IgA lambda type. Her serum was positive for hepatitis C virus infection and exhibited elevated levels of serum protein induced by vitamin K absence or antagonist-II. She was initially diagnosed as rupture of hepatocellular carcinoma (HCC) and then treated with transarterial chemoembolization (TACE) since bloody ascites and formation of hematoma were seen around hyper-vascular liver tumors on computed tomography. However, the clinical course of this case after TACE was atypical for HCC rupture, as shown by the development of a huge intra-abdominal abscess extending from the liver tumor. Immuno-histochemical analysis of the tumor biopsy specimen revealed massive infiltration of plasma cells expressing IgA and lambda chain. To our knowledge, this is the first case of rupture of extramedullary liver plasmacytoma.
Ueda
Kosuke
K
Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto.
Matsui
Hiroyuki
H
Watanabe
Tomohiro
T
Seki
Junya
J
Ichinohe
Tatsuo
T
Tsuji
Yoshihisa
Y
Matsumura
Kayoko
K
Sawai
Yugo
Y
Ida
Hiroshi
H
Ueda
Yoshihide
Y
Chiba
Tsutomu
T
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy; D010954:Plasmacytoma / Q000175:diagnosis* / Q000628:therapy; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000628:therapy