Extramedullary plasmacytoma mimicking colon carcinoma: an unusual presentation and review of the literature.
A 72-year-old woman presented to outpatient clinic with fatigue, light-headedness, dyspnoea and dark stool suggestive of lower gastrointestinal bleeding. She was previously diagnosed with multiple myeloma and completed 9 cycles of chemotherapy with bortezomib, lenalidomide and dexamethasone. She had very good partial response. A CT scan of the abdomen revealed a 9 cm mass at the hepatic flexure of the large intestine with an apple core deformity causing a marked narrowing of the lumen. Colonoscopy confirmed a large, nearly obstructing ulcerative mass in the distal right colon. The patient underwent a right hemicolectomy, distal ileal resection and lymph node dissection. Histopathology confirmed the mass as a plasmacytoma. Postoperatively, the patient was started with bortezomib and liposomal doxorubicin followed by carfilzomib. She showed excellent response to the chemotherapy.
Department of Internal Medicine, Texas Tech University, Amarillo, Texas, USA.
Kaela
K
Parnell
Texas Tech University, Amarillo, Texas, USA.
Mashrafi
M
Ahmed
Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas, USA.
Roger D
RD
Smalligan
Department of Internal Medicine, Texas Tech University, Amarillo, Texas, USA.
Suhasini
S
Nadesan
D000368:Aged; D003082:Colectomy; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004244:Dizziness / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery