Gastrointestinal bleeding as initial presentation of extramedullary plasma cell neoplasms: A case report and review of the literature

Table 1 Case reports from the literature review performed

Ref.	Year	Age	Gender	Location of EMP	Presenting Complaint	Outcome	Other symptoms	Primary or Secondary	Diagnostic tests	Treatment
Line et al[7]	1969	46	Male	Gastric	Melena	Dead after 2 yr	Bone pain and swelling, weight loss, indigestion	Secondary	Barium meal, laparotomy	STx
Yasar et al[8]	2015	69	Male	Gastric	Melena, Haematemesis	N/A	None	Secondary (BG: MM)	OGD	N/A
Krishnamoorthy et al[9]	2010	57	Male	Gastric	Melena	N/A	None	Primary	OGD	N/A
Morinaga et al[10]	2010	61	Male	Gastric	Melena	N/A	Abdominal distention	Primary	CT AP OGD	N/A
Ruiz Montes et al[11]	1995	N/A	N/A	Gastric	Upper GI Bleeding	N/A	None	Primary	OGD	N/A
Katodritou et al[12]	2008	68	Male	Gastric	Upper GI Bleeding	Remission 13 mo post diagnosis	None	Primary	OGD	CTx (Bortezomib + Dexamethasone)
Chim et al[13]	2002	N/A	N/A	Gastric	Melena	N/A	N/A	Secondary (new Dx of MM)	OGD	N/A
Sanal et al[14]	1996	75	Male	Gastric	Melena	N/A	Obstructive jaundice (pancreatic plasmacytoma), bony lesions, Skin lesions	Secondary (BG: MM)	OGD	N/A
Güngör et al[15]	2009	77	Male	Gastric	Melena	N/A	Skin lesions	Secondary (BG: MM)	OGD	CTx
Daram et al[3]	2012	53	Female	Gastric Duodenal	Haematemesis	N/A	None	Secondary (BG: MM)	OGD	N/A
Sloyer et al[16]	1988	60	Male	Gastric	Melena	N/A	Bone pain (bony lesions)	Secondary (BG: MM)	OGD	N/A
Hamilton et al[17]	1999	53	Male	Gastric	Melena/Haematemesis	Dead in < 12 mo	Epigastric pain Previous orbital plasmacytoma	Secondary (new Dx of MM)	OGD	CTx
Maskin et al[22]	2008	53	Male	Gastric/Duodenal	UGI Bleeding	N/A	Back pain (bony lesions), Anorexia, Vomiting	Secondary (new Dx of MM)	OGD	N/A
Ammar et al[23]	2010	69	Female	Gastric/Duodenal	Melena	Alive (report in 2012)	Fatigue	Primary	OGD	RTx (Patient not fit for ChemoTx/Surg) PTC for subsequent biliary obstruction
Lin et al[2]	2012	47	Male	Gastric/Duodenal	Haemato -chezia	Alive for 6-mo follow up	Palpitations	Secondary (new Dx of MM)	OGD, small capsule endoscopy	CTx (Melphalan,prednisone, oral thalidomide) +/- Stem cell transplantation
Wang et al[24]	2013	52	Female	Gastric/Duodenal	Melena	Dead after 2 mo	Back pain, weakness (bony lesions), dyspnoea (pleural effusion)	Secondary (new Dx of MM)	OGD	N/A
Esfandyari et al[25]	2007	70	Male	Gastric/Duodenal	Anaemia	Dead	Astenia	Secondary (BG: MM)	OGD	CTx
Gradishar et al[18]	1988	65	Male	Duodenal	Melena	Alive (reported in 2012)	Abdominal pain, obstruction	Secondary (BG: MM)	OGD	RTx STx
Siddique et al[19]	1999	N/A	N/A	Duodenal	Melena	N/A	None	Primary	OGD	Gastroduodenal artery embolization
Fowell et al[20]	2007	88	Male	Duodenal	UGI Bleeding	N/A	Abdominal pain, dyspepsia, diarrhoea, fever, weight loss	Primary	OGD	N/A
Licci et al[21]	2017	60	Female	Duodenal	Melena Anaemia	N/A	Weight loss	Secondary (High-grade plasma cell myeloma)	OGD	CTx
Prachayakul et al[30]	2013	48	Male	Duodenumjejunum, ileum	UGI Bleeding	N/A	Abdominal pain + Diarrhoea Bony lesions	Secondary (new Dx of MM)	OGD	CTx
Ingegno et al[26]	1954	51	Female	Jejunum	Haematemesis	Alive after 32 mo	None	Primary	OGD	STx
Michotey et al[27]	1970	N/A	N/A	Jejunum	Melena, Anaemia	N/A	Abdominal pain	Primary	OGD	STx
Reddy et al[28]	2015	69	Male	Jejunum	Melena, Anaemia	N/A	None	Secondary (BG of plasmablastic myeloma)	OGD, Small bowel endoscopy, double balloon endero-scopy	CTx (cyclophosphamide, bortezomib, dexamethasone) +/- stem cell transplantation
Fisher et al[29]	1975	81	Male	Ileum	Melena	N/A	Obstruction, skin lesions, lymphadeno-pathy	Primary	OGD Laparotomy	STx
Monohan et al[31]	2018	70	Male	Ileum	Melena, Anaemia	Died 6 mo after diagnosis	Bony lesions	Secondary (BG of plasma-blastic myeloma)	OGD Colono-scopy Small capsule endoscopy CT Angiogram	CTx STx (emergency)

EMP: Extramedullary Plasmacytoma; N/A: N/A; OGD: Oesophagogastroscopy; GI: Gastrointestinal; CTx: Chemotherapy; RTx: Radiotherapy; STx: Surgery; MM: Multiple myeloma; Dx: Diagnosis; CT AP: Computed tomography abdomen and pelvis; UGI: Upper gastrointestinal.