Successful treatment of primary advanced gastric plasmacytoma using a combination of surgical resection and chemotherapy with bortezomib: A case report.
BACKGROUND
Extramedullary plasmacytoma (EMP) is a plasma cell neoplasm that presents as a solitary tumor. EMP in the gastrointestinal organs are extremely uncommon.


METHODS
A 36-year-old man was admitted to our hospital with advanced anemia. He had no specific medical history. Gastroendoscopic findings showed an 8.0-cm submucosal tumor with ulcer on the greater curvature of the gastric body. Fine-needle aspiration was performed, and the pathologic diagnosis of the submucosal tumor was a plasmacytoma. Therefore, the patient was diagnosed with gastric plasmacytoma. A total gastrectomy was performed with lymphadenectomy. The result of intraoperative peritoneal lavage cytology was positive. Histological examination revealed serosa-exposed plasmacytoma of the stomach with lymph nodes metastasis. Additionaly the patient received a three-drug chemotherapy regimen (bortezomib, cyclophosphamide, and dexamethasone [VCD]) from 3 weeks after the operation. After 4 cycles of chemotherapy, the patient received autologous peripheral blood stem-cell transplantation (auto-PBSCT). Eighteen months after diagnosis, the patient is in complete remission with no evidence of local relapse or evolution to multiple myeloma.


CONCLUSIONS
This is the first reported case of advanced gastric plasmacytoma using adjuvant chemotherapy involving bortezomib and auto-PBSCT after the resection, and the patient has maintained a good course over a year. This protocol could be a new way to treat these tumors.
Department of Surgery, Chugoku Rosai Hospital, 1-5-1, Tagaya, Hiro, Kure City, Hiroshima 737-0193, Japan.
Sotaro
S
Fukuhara
Department of Surgery, Chugoku Rosai Hospital, 1-5-1, Tagaya, Hiro, Kure City, Hiroshima 737-0193, Japan. Electronic address: thiroes@gmail.com.
Hirofumi
H
Tazawa
Department of Internal Medicine, Chugoku Rosai Hospital, 1-5-1, Tagaya, Hiro, Kure City, Hiroshima 737-0193, Japan.
Hideharu
H
Okanobu
Department of Hematology, National Hospital Organization Kure Medical Center, 3-1, Aoyamatyo, Kure City, Hiroshima 737-0023, Japan.
Michiko
M
Kida
Department of Hematology, National Hospital Organization Kure Medical Center, 3-1, Aoyamatyo, Kure City, Hiroshima 737-0023, Japan.
Miki
M
Kido
Department of Hematology, National Hospital Organization Kure Medical Center, 3-1, Aoyamatyo, Kure City, Hiroshima 737-0023, Japan.
Toshiro
T
Takafuta
Department of Diagnostic Pathology, Chugoku Rosai Hospital, 1-5-1, Tagaya, Hiro, Kure City, Hiroshima 737-0193, Japan.
Toshihiro
T
Nishida
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Hideki
H
Ohdan
Department of Surgery, Chugoku Rosai Hospital, 1-5-1, Tagaya, Hiro, Kure City, Hiroshima 737-0193, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Hideto
H
Sakimoto
Chemotherapy; Plasmacytoma; Stomach; Surgical resection