Successful Treatment of a Gastric Plasmacytoma Using a Combination of Endoscopic Submucosal Dissection and Oral Thalidomide

Abstract

We report a rare case of a gastric plasmacytoma treated with endoscopic resection and oral thalidomide therapy. A 70-year-old man was admitted to our hospital with indigestion. He had no specific medical history and unremarkable laboratory results. Gastroendoscopic findings revealed a focal, erythematous, flat elevated lesion in the anterior wall of the stomach antrum. A biopsy revealed atypical lymphocytes. Endoscopic submucosal dissection (ESD) with an insulation-tipped knife was performed 45 days after diagnosis. Radiological and hematological evaluations, including a bone marrow biopsy, were performed and showed no involvement of other organs. The patient was diagnosed with extramedullary gastric plasmacytoma. Follow-up gastroendoscopy was performed three times during a 2-year period and showed nonspecific ESD scarring. The patient's condition was found to be stable.

Intestinal perforation with abdominal abscess caused by extramedullary plasmacytoma of small intestine: A case report and literature review

“…The patient underwent emergency surgery without postoperative adjuvant chemotherapy with no recurrence after 14 mo of regular follow-up. In recent years, endoscopic treatments, such as endoscopic mucosal resection or endoscopic submucosal dissection, have become increasingly popular in gastrointestinal EMP surgery and have obtained a good therapeutic effect[ 18 , 20 , 25 ]. Due to the high sensitivity of primary EMP to radiotherapy, local radiotherapy is also an effective treatment method[ 45 , 48 ].…”

Successful treatment of primary advanced gastric plasmacytoma using a combination of surgical resection and chemotherapy with bortezomib: A case report

“…The invasion depth of the 15 cases had been pT4 (SE), indicating that patients with gastric plasmacytoma with invasion to the serosa have a markedly poorer prognosis than the others. Most of the cases reported in the literature are early stage of gastric plasmacytom, and these cases have been treated with endscopic submucosal dissection [9] , [10] , [11] . Until now, there has been few evidence that additional chemotherapy is beneficial.…”

Endoscopic submucosal dissection of a solitary gastric plasmacytoma: “third space oddity”

“…Although well established for classic indications 1 2 3 , the use of endoscopic submucosal dissection (ESD) can help to solve rare clinical situations 4 5 .…”

“…Although well established for classic indications [1][2][3], the use of endoscopic submucosal dissection (ESD) can help to solve rare clinical situations [4][5]. A 35-year-old woman without medical history underwent an esophagogastroduodenoscopy for progressive epigastralgia that was unresponsive to proton pump inhibitors (PPIs) for 12 months.…”