title: Extramedullary Plasmacytoma Mimicking Pancreatic Cancer: An Unusual Presentation.
abstract: Multiple myeloma is a plasma cell tumor that homes to and expands in the bone marrow and that, despite the new available drugs, remains incurable. Extramedullary plasmacytoma is a not frequent manifestation during the natural history of multiple myeloma and is frequently associated with plasma cell bone marrow infiltration. The most common locations for an EMP include the gastrointestinal tract, pleura, testis, skin, peritoneum, liver, endocrine glands, and lymph nodes. Primary involvement of the gallbladder fossa is exceedingly rare. In this report, we describe a patient with multiple myeloma who achieved a clinical and serological remission after autologous transplant but progressed rapidly at extramedullary site mimicking a second cancer (i.e., pancreatic or biliary cancer). In this case, the extramedullary localization was refractory to standard therapy, differently from bone marrow localization, but responded to lymphoma-like therapy. In this patient (i) the particular site of developing plasmacytoma is the gallbladder fossa, (ii) the timing of onset of this neoplasm is immediately after autologous transplant, and (iii) its disjunction from primary myeloma is that it appears in clinical and serological remission phase which may be confounding during the diagnostic approach simulating a different tumor (solid tumor).
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari, Bari, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Sciancalepore
authors.affiliation: Cardiology Unit, San Paolo Hospital, Contrada Caposcardicchio, Bari, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Musci
authors.affiliation: Radiology Unit, San Paolo Hospital, Contrada Caposcardicchio, Bari, Italy.
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Fracella
authors.affiliation: Radiology Unit, San Paolo Hospital, Contrada Caposcardicchio, Bari, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: D'Alesio
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari, Bari, Italy.
authors.forename: Azzurra
authors.initials: A
authors.lastname: Sportelli
authors.affiliation: Department of Pathology, University of Bari, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ingravallo
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari, Bari, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Vacca
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari, Bari, Italy.
authors.forename: Roberto
authors.identifier: 0000-0002-1515-0090
authors.initials: R
authors.lastname: Ria