A Case of Multiple Myeloma Associated with Extramedullary Plasmacytoma of the Gallbladder Manifesting as Acute Cholecystitis

Abughanimeh, Omar; Qasrawi, Ayman; Omar, M. A. K.; Bahaj, Waled; Ghanimeh, Mouhanna Abu

doi:10.7759/cureus.2688

Cited by 5 publications

(15 citation statements)

References 17 publications

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“…Multiple Myeloma is a plasma cell disorder that accounts for approximately 10% of all hematologic malignancies [ 1 ]. It commonly affects more men than women at a 3:2 ratio and is twice as common amongst the African American population, with the average age of onset at 50-70 years [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple Myeloma (MM) is a neoplastic proliferation of plasma cells inside the bone marrow. The infiltration of these cells into the bone marrow leads to the suppression of hematopoiesis [ 1 ]. This disorder accounts for approximately 10% of all hematologic malignancies.…”

Section: Introductionmentioning

confidence: 99%

“…Patients with multiple myeloma can develop EMP at the time of diagnosis or at the time of relapse [ 3 ]. Irrespective of the time it is diagnosed, EMP remains a poor prognostic marker and a therapeutic dilemma [ 1 ]. In patients with already established MM, the diagnosis of EMP is made by radiologic modalities which include computed tomography, positron emission tomography (PET)/CT, magnetic resonance imaging (MRI), ultrasound, biopsy, or at times with physical examination [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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A Rare Case of Extra-Medullary Portacaval Plasmacytoma in a Patient With Relapsed Multiple Myeloma

Bethel¹,

Ajayi²,

Asrar³

et al. 2022

Cureus

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Multiple myeloma (Kahler disease) is a monoclonal plasma cell immunoproliferative neoplasm originating within the bone marrow that involves the production of monoclonal immunoglobulins, mostly IgG and IgA. Extramedullary plasmacytoma (EMP) is a subset of plasma cell neoplasms that can develop in patients at the time of diagnosis with multiple myeloma, or relapse of the disease. Symptoms related to plasmacytomas depend on the primary location. Here in, we present a rare case of extramedullary plasmacytoma involving the portacaval space in an 83-year-old African American female with relapsed multiple myeloma. She was treated successfully with radiation therapy with complete resolution of the mass. In this case report, we aim to discuss the clinical features along with diagnostic methods and treatment for extramedullary plasmacytomas with emphasis on utilizing a multidisciplinary approach in managing these rare cases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Rare Case of Extra-Medullary Portacaval Plasmacytoma in a Patient With Relapsed Multiple Myeloma

Bethel¹,

Ajayi²,

Asrar³

et al. 2022

Cureus

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“…Gallbladder involvement in EMM, however, is extremely rare, with only 8 cases found in the English medical literature. 4 - 11 …”

Section: Introductionmentioning

confidence: 99%

Secondary Extramedullary Myeloma of the Gallbladder: A Case Report

Kolagatla

Jenkins

Strunk

et al. 2022

Journal of Investigative Medicine High Impact Case Reports

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Extramedullary myeloma (EMM) is an infrequent but well-established manifestation of multiple myeloma (MM), defined as a soft tissue plasma cell neoplasm without bone marrow involvement. Gallbladder involvement in EMM, however, is a very rare occurrence, with only 8 cases found in the English medical literature. Here, we present a case of an older adult male with a gallbladder mass in the presence of increasing serum kappa light chains after a normal bone marrow biopsy confirmed the complete remission of a previous MM diagnosis. Histopathologic evaluation of a biopsied sample confirmed the mass as an atypical plasma cell neoplasm. Later in his treatment, he developed several firm, smooth, violaceous skin nodules on the torso, which histopathology confirmed as also being atypical plasma cell neoplasms. We aim to contribute to the medical literature by expanding the pool of information regarding EMM of the gallbladder to support future diagnostic and treatment recommendations.

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“…These monoclonal plasma cells proliferate in bone marrow and produce abnormal antibodies as well as light chains called paraproteins, which are a feature of diagnosing multiple myeloma. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

Multiple Myeloma Plasmacytoid Infiltration of the Gallbladder Presenting as Acute Cholecystitis

Alyass¹,

Narh-Martey²

2021

CRSLS

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Secondary distal plasmacytoma that arise from multiple myeloma is a common hematological malignancy that manifests in later stages of the disease. These plasmacytomas are known to cause extensive systemic organ damage. When extramedullary plasmacytomas reach the gallbladder or biliary ducts, expansion can mimic acute acalculous cholecystitis or cholangiocarcinoma. We report a case of a 56-year-old female with a history of aggressive course IgA κ chain multiple myeloma who presented with right upper quadrant abdominal pain with nausea and vomiting for one week duration. Her laboratory panel revealed liver function tests consistent with gallbladder etiology. Abdominal ultrasound and CT showed no evidence of cholelithiasis precluding to acute acalculous cholecystitis. Initial medical management did not show any improvement. A robotic cholecystectomy was performed, and a pathology review of the specimen found a neoplastic stricture of the gallbladder fundus, the histological evaluation of which revealed plasmacytoid cells originating from her primary multiple myeloma diagnosis. The patient’s condition declined following surgery, postoperative presentation included metastatic liver thrombosis mimicking cholangiocarcinoma and the patient later expired with palliative care.

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A Case of Multiple Myeloma Associated with Extramedullary Plasmacytoma of the Gallbladder Manifesting as Acute Cholecystitis

Cited by 5 publications

References 17 publications

A Rare Case of Extra-Medullary Portacaval Plasmacytoma in a Patient With Relapsed Multiple Myeloma

A Rare Case of Extra-Medullary Portacaval Plasmacytoma in a Patient With Relapsed Multiple Myeloma

Secondary Extramedullary Myeloma of the Gallbladder: A Case Report

Multiple Myeloma Plasmacytoid Infiltration of the Gallbladder Presenting as Acute Cholecystitis

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