Metastase eines medullären Plasmozytoms als Ursache einer akuten Cholezystitis

Abstract

Secondary tumours of the gallbladder considered are thought to be rare. Since 1863 only 95 cases have been reported. The case discussed here is only the second one in which the metastatic tumor was a medullary plasmocytoma. But a search for published and confirmed cases indicates that secondary tumors of the gall bladder are not so rare. Metastatic tumors of the gall bladder should be kept in mind in the differential diagnosis of acute cholecystitis, especially in patients with an advanced primary tumor.

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

“…Per our literature search, eight cases of extramedullary plasmacytomas of the GB or biliary ducts were found [ 7 - 14 ]. Four cases were associated with MM, [ 9 - 10 , 12 , 14 ] and the other four were for solitary [ 7 - 8 , 11 , 13 ]. Table 2 summarizes these cases.…”

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

“…GB and biliary involvement by extramedullary plasmacytoma, whether solitary or as a secondary infiltration associated with MM, is rare and has only been described in case reports [7][8][9][10][11][12][13][14]. Such involvement may manifest similarly to primary cholangiocarcinoma, primary GB cancer or other common benign inflammatory, infectious, or obstructive diseases of the GB and biliary ducts [7][8][9][10][11][12][13][14]. Therefore, these extramedullary plasmacytomas are not typically considered in the differential diagnosis of biliary diseases, and the majority of cases are detected post-operatively or post-mortem [8].…”

“…Clinically, extramedullary plasmacytomas of the GB or biliary ducts can be asymptomatic or manifest as obstructive jaundice, vague abdominal pain, or, rarely, as acute cholecystitis with constant abdominal pain, tenderness to palpation, and positive Murphy sign [7][8][9][10][11][12][13][14].…”

“…Radiologically, a thickened GB wall, dilated biliary ducts, or enlarged lymph nodes can be detected [7][8][9][10][11][12][13][14].…”

“…However, MM can be complicated by secondary plasmacytomas, which are usually associated with a more aggressive course, shorter progression-free survival, and worse prognosis [1,4,[6][7]. The involvement of the gall bladder (GB) and biliary ducts by plasma cell neoplasms, whether solitary plasmacytomas or MM with secondary plasmacytomas, is rare [7][8][9][10][11][12][13][14]. The clinical and radiological manifestations of GB involvement can be confused with many benign and malignant diseases.…”