BACKGROUND: Only few cases of pancreatic involvement of multiple myeloma (MM) have been reported in the medical literature. PATIENTS AND METHODS: We here report a case of devastating extramedullary relapse of IgA/lambdaMM (stage IA) treated at diagnosis with a dexamethasone, adriamycin, vincristine (DAV) regimen followed by high-dose therapy and autologous stem cell transplantation (ASCT), achieving a partial remission. After 6 years of stable disease, the patient presented symptoms of obstructive jaundice determined by a large mass of the head of the pancreas. An ultrasound-guided fine-needle aspiration cytology of the pancreatic mass revealed the presence of myeloma plasma cells. A chest X-ray demonstrated a massive right pleural effusion, and the cytomorphologic evaluation of the pleural effusion showed the presence of abnormal plasma cells. RESULTS: We observed a progression of disease despite an aggressive treatment with high-dose cyclophosphamide. CONCLUSIONS: Our case shows that extramedullary relapses of MM after ASCT are very resistant to conventional chemotherapy. The role of new drugs and the optimal treatment strategy in these cases remain to be defined. Copyright 2009 S. Karger AG, Basel.
BACKGROUND: Only few cases of pancreatic involvement of multiple myeloma (MM) have been reported in the medical literature. PATIENTS AND METHODS: We here report a case of devastating extramedullary relapse of IgA/lambdaMM (stage IA) treated at diagnosis with a dexamethasone, adriamycin, vincristine (DAV) regimen followed by high-dose therapy and autologous stem cell transplantation (ASCT), achieving a partial remission. After 6 years of stable disease, the patient presented symptoms of obstructive jaundice determined by a large mass of the head of the pancreas. An ultrasound-guided fine-needle aspiration cytology of the pancreatic mass revealed the presence of myeloma plasma cells. A chest X-ray demonstrated a massive right pleural effusion, and the cytomorphologic evaluation of the pleural effusion showed the presence of abnormal plasma cells. RESULTS: We observed a progression of disease despite an aggressive treatment with high-dose cyclophosphamide. CONCLUSIONS: Our case shows that extramedullary relapses of MM after ASCT are very resistant to conventional chemotherapy. The role of new drugs and the optimal treatment strategy in these cases remain to be defined. Copyright 2009 S. Karger AG, Basel.
Authors: Tagore Sunkara; Santosh R Sharma; Andrew Ofosu; Vinaya Gaduputi; Madhavi Reddy; Ghulamullah Shahzad Journal: J Investig Med High Impact Case Rep Date: 2018-05-24
Authors: Almed K Alomari; Berrin Ustun; Harry R Aslanian; Xinquan Ge; David Chhieng; Guoping Cai Journal: Cytojournal Date: 2016-01-28 Impact factor: 2.091