Difficult endoscopic diagnosis of a pancreatic plasmacytoma: Case report and review of literature

Williet, Nicolas; Kassir, Radwan; Cuilleron, Muriel; Dumas, Olivier; Rinaldi, Leslie; Augeul-Meunier, Karine; Cottier, Michèle; Roblin, Xavier; Phelip, Jean-Marc

doi:10.5306/wjco.v8.i1.91

Cited by 13 publications

(14 citation statements)

References 12 publications

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“…Common signs and symptoms in patients with pancreatic plasmacytoma included abdominal pain, obstructive jaundice, and anorexia, which were also seen in our patient [ 3 ]. These symptoms raise a concern for a pancreatic adenocarcinoma, especially when there is biliary obstruction as well.…”

Section: Discussionmentioning

confidence: 57%

“…Plasmacytoma is a solitary tumor of plasma cells. Since the first case report of pancreatic plasmacytoma by Hefferman published in 1947 [ 2 ], there have been about 63 English literatures published [ 3 ]. Plasmacytoma of pancreas often raises a concern for adenocarcinoma as their clinical presentations are similar, such as, abdominal pain, weight loss, asthenia, and anorexia.…”

Section: Introductionmentioning

confidence: 99%

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Biliary Obstruction due to a Pancreatic Plasmacytoma

Cho

Mandaliya

Tran

et al. 2018

Case Reports in Gastrointestinal Medicine

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Obstructive jaundice, weight loss, and anorexia often raise a concern for pancreatic malignancy. Although pancreatic adenocarcinoma is the most common form of pancreatic cancer, not all pancreatic malignancies are exocrine in origin. With advancement in endoscopic ultrasound with fine needle aspiration, it has become easier to make correct diagnosis. Plasmacytoma of pancreas is a solitary tumor of plasma cells and it can also lead to the same clinical presentations. Immunohistochemistry is required to make the diagnosis of plasmacytoma. However, when there are other systemic manifestations, such as hypercalcemia, renal injury, and anemia, a diagnosis of multiple myeloma should be suspected and confirmed by cytology or biopsy. It is very important to differentiate plasmacytoma from multiple myeloma as the management for each is different. Herein, we describe a case of multiple myeloma presenting as a pancreatic plasmacytoma causing obstructive jaundice.

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Biliary Obstruction due to a Pancreatic Plasmacytoma

Cho

Mandaliya

Tran

et al. 2018

Case Reports in Gastrointestinal Medicine

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“…Currently, there are about 70 cases of pancreas plasmacytoma reported, 34 cases of multiple myeloma involving the pancreas, which are mostly diagnosed multiple myeloma first and then present pancreas involvement subsequently. [8] Multiple myeloma with onset of pancreas involvement was first reported in 1958 and 8 cases have been reported so far (Table 1). [9–16]…”

Section: Discussionmentioning

confidence: 99%

Multiple myeloma with onset of pancreas involvement

Wang¹,

Xie²,

Zhang

2019

Medicine

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Rationale: Multiple myeloma is the second most common hematological malignancy. Extramedullary involvement is one of the indicators of poor prognosis. There is no consensus in treatment options and the efficacy. This article reports a case of multiple myeloma with onset of pancreas involvement. Amyloidosis secondary to multiple myeloma and a partial response to the chemotherapy treatment further emphasized its rarity. Patient concerns: In this article, we report a 59-year-old male patient with a chief complaint of fatigue for 8 months and upper abdominal pain for 2 months. Diagnosis: The patients were diagnosed as amyloidosis secondary to multiple myeloma with pancreatic occupying (head–neck junction area) lesion based on laboratory examination and pathology from lymph node puncture and skin biopsy. Interventions: An intensive chemotherapy treatment as bortezomib, lenalidomide, dexamethasone, cisplatin, epirubicin, cyclophosphamide, and etoposide was given. Due to intolerance, treatment regimen was further adjusted to bortezomib, lenalidomide, and dexamethasone. Outcomes: The patient was 12 months alive. After 4 cycles of chemotherapy, a partial response was achieved and abdominal magnetic resonance imaging suggested a reduced pancreatic occupying lesion. Lessons: This case demonstrates that pancreatic involvement, digestive system neoplasm, and amyloidosis-related clinical features may be the earliest manifestations of multiple myeloma. For these patients, an intensive chemotherapy regimen may be a possible treatment approach.

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“…To date, there are more than 63 cases in the English literature of EMP with pancreatic involvement. 4,5 Although they can develop in any part of the pancreas, many of these lesions are in the pancreatic head. The patient described in our case report has a large pancreatic body mass encasing the portal vein as well as the celiac artery which is even rarer in presentation.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Extramedullary Plasmacytoma Presenting as a Pancreatic Mass

Surapaneni

Jain

et al. 2018

Clin Med Insights Gastroenterol

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Extramedullary plasmacytomas (EMP) are a subcategory of plasma cell neoplasm that involves organs outside the bone marrow. Involvement of the pancreas is relatively rare, reported in only 2.3% of autopsies. Radiologic findings in plasmacytoma are nonspecific, but endoscopic ultrasound fine-needle aspiration is a fast and reliable technique to acquire a histologic sample for initial diagnosis. Recently, the use of fluorine-18 fluorodeoxyglucose PET/CT has been recommended in patients with active multiple myeloma and solitary plasmacytoma. We present an interesting case of primary EMP in the pancreatic body encasing the portal vein as well as the celiac artery, which was detected before the patient was diagnosed of multiple myeloma.

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Difficult endoscopic diagnosis of a pancreatic plasmacytoma: Case report and review of literature

Cited by 13 publications

References 12 publications

Biliary Obstruction due to a Pancreatic Plasmacytoma

Biliary Obstruction due to a Pancreatic Plasmacytoma

Multiple myeloma with onset of pancreas involvement

Pancreatic Extramedullary Plasmacytoma Presenting as a Pancreatic Mass

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