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Carella A, Spannella F, Morè S, Grifoni R, Settanni CR, Mandolesi A, Filosa A, Goteri G, Boccoli G, Fava G. A rare case of solitary plasmacytoma mimicking submucosal lesion of ascending colon: a case report and literature review. Front Oncol 2024; 14:1430745. [PMID: 39267849 PMCID: PMC11390380 DOI: 10.3389/fonc.2024.1430745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/02/2024] [Indexed: 09/15/2024] Open
Abstract
Solitary primary extraosseous plasmacytoma is a rare disease in the gastrointestinal tract, recently classified as an "exceptional" tumor of the colon site. The real incidence (one case/population/year) is unknown but reasonably less than 1/10,000,000 cases/year with very few descriptions in the literature. The rare cases described in the literature are often diagnosed after surgery for perforation and with predominant localization of the left colon. The main endoscopic presentation mimics colon carcinoma with ulcerated mass and obstructing lumen. In this paper, we report a rare case of isolated mass mimicking a submucosal lesion of the ascending colon diagnosed in an older female patient by colonoscopy. The patient was almost asymptomatic; she reported only a history of hematochezia without anemia. This mass was successfully treated by surgery and followed by hematological investigations, including bone marrow biopsy, specific laboratory tests, and CT/PET scan, which confirmed primary isolated plasmacytoma of the colon.
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Affiliation(s)
- Alessandra Carella
- Unit of Gastroenterology and Digestive Endoscopy, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
- Department of Clinical and Molecular Sciences, University “Politecnica Delle Marche”, Ancona, Italy
| | - Sonia Morè
- Department of Clinical and Molecular Sciences, University “Politecnica Delle Marche”, Ancona, Italy
- Hematology Clinic, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Riccardo Grifoni
- Department of General Surgery, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
| | - Carlo Romano Settanni
- Unit of Gastroenterology and Digestive Endoscopy, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
| | - Alessandra Mandolesi
- Anatomic Pathology, Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, Ancona, Italy
| | - Alessandra Filosa
- Anatomic Pathology, Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, Ancona, Italy
| | - Gaia Goteri
- Anatomic Pathology, Department of Biomedical Sciences and Public Health, University “Politecnica delle Marche”, Ancona, Italy
| | - Gianfranco Boccoli
- Department of General Surgery, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
| | - Giammarco Fava
- Unit of Gastroenterology and Digestive Endoscopy, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Italian National Research Centres on Aging (INRCA), Ancona, Italy
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Alfar R, Kamal N, Abdel Razeq R, Omari Z, Bater R, Sharaf B. A Durable Response of Primary Advanced Colonic Plasmacytoma Using a Combination of Surgical Resection and Adjuvant Bortezomib: A Case Report and Literature Review. Onco Targets Ther 2022; 15:1347-1354. [DOI: 10.2147/ott.s372534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/25/2022] [Indexed: 11/09/2022] Open
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Wang KW, Xiao N. Intestinal perforation with abdominal abscess caused by extramedullary plasmacytoma of small intestine: A case report and literature review. World J Gastrointest Surg 2022; 14:611-620. [PMID: 35979418 PMCID: PMC9258233 DOI: 10.4240/wjgs.v14.i6.611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/26/2022] [Accepted: 05/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Extramedullary plasmacytoma (EMP) of the gastrointestinal tract is an extremely rare disease. Clinical manifestations of EMPs are varied and depend on the location and progression of the tumor.
CASE SUMMARY Here, we firstly report a case of intestinal perforation with abdominal abscess caused by EMP of the small intestine in a 55-year-old female patient. The patient received emergency surgery immediately after the necessary preoperative procedures. During the operation, EMP was found to have caused the perforation of the small intestine and the formation of multiple abscesses in the abdominal cavity. Partial resection of the small intestine with peritoneal irrigation and drainage was performed. EMP was finally confirmed by postoperative histopathology and laboratory tests. Additionally, we performed a literature review of gastrointestinal EMP to obtain a deeper understanding of this disease.
CONCLUSION EMP of the small intestine may have spontaneous perforation, which requires emergency surgery. Surgical resection can obtain good therapeutic effects.
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Affiliation(s)
- Ke-Wei Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Nan Xiao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Mesa López MJ, Salazar Nicolás A, Leal Rubio JD, Muñoz Tornero M, Egea Valenzuela J. Extramedullary plasmacytoma with colonic involvement: experience of two cases in a tertiary hospital. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2022; 114:629-630. [DOI: 10.17235/reed.2022.8828/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fagkrezos D, Manes K, Paraskeva K, Lenos M, Triantopoulou C, Apessou D, Maniatis P. Secondary extramedullary plasmacytoma of sigmoid colon in a patient with multiple myeloma: a case report. J Med Case Rep 2018; 12:379. [PMID: 30583721 PMCID: PMC6305571 DOI: 10.1186/s13256-018-1888-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023] Open
Abstract
Background Extramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to another plasma cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease. Involvement of the gastrointestinal tract occurs in approximately 10% of cases. Case presentation A 71-year-old Caucasian woman with known diverticular disease of the colon and multiple myeloma diagnosed 3 years previously, with monoclonal bands of immunoglobulin A, lambda light chains, and multiple osteolytic lesions, presented to our hospital with abdominal pain, abdominal discomfort, and pneumoperitoneum. She underwent left colectomy for diverticulitis with perforation, and an extramedullary secondary colonic plasmacytoma was found in histopathological examination of the sigmoid colon. Conclusions Plasmacytoma is known to occur in extraosseous sites. The stomach and small intestine are the most commonly involved sites in the gastrointestinal tract. Secondary extramedullary plasmacytoma of the colon is rare. Colonic plasmacytoma may have varying clinical presentations, such as inflammatory bowel disease and multiple colonic strictures. Although these cases are rare, treating physicians as well as radiologists, pathologists, and surgeons should be aware of this entity.
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Affiliation(s)
- Dimitris Fagkrezos
- Computed Tomography Department, Konstantpouleio General Hospital Nea Ionia, Athens, Greece.
| | - Konstantinos Manes
- Surgery Department, Konstantpouleio General Hospital Nea Ionia, Athens, Greece
| | - Konstantina Paraskeva
- Gastroenterology Department, Konstantpouleio General Hospital Nea Ionia, Athens, Greece
| | - Michalis Lenos
- Pathology Department, Konstantopouleio General Hospital Nea Ionia, Athens, Greece
| | | | - Dimitra Apessou
- Pathology Department, Konstantopouleio General Hospital Nea Ionia, Athens, Greece
| | - Petros Maniatis
- Computed Tomography Department, Konstantpouleio General Hospital Nea Ionia, Athens, Greece
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Miwa W, Hiratsuka T, Tei S, Sato K, Yo K. Solitary extramedullary plasmacytoma of the rectum complicating ulcerative colitis. Clin J Gastroenterol 2018; 12:160-165. [PMID: 30238285 DOI: 10.1007/s12328-018-0907-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/13/2018] [Indexed: 01/09/2023]
Abstract
Solitary extramedullary plasmacytoma (EMP) arising in the rectum is an extremely rare clinical entity. Only ten cases have been reported in the English-language literature. We experienced a case of an EMP in the rectum of a 55-year-old man with an 8-year history of proctitis-type ulcerative colitis (UC). The plasmacytoma appeared as an 8-mm semipedunculated polypoid lesion in the actively inflamed rectal mucosa when the remittent UC flared. The tumor was treated using endoscopic mucosal resection. This is the second case of rectal EMP associated with UC after a similar report was published in 2004. Both patients had a chronic history of proctitis-type UC and were taking no immunosuppressive agents that could cause Epstein-Barr virus-associated plasmacytoma, such as thiopurines. The UC activity seemed to correspond well with the development of the rectal EMP. Therefore, we herein discuss a possible association between rectal EMP and UC and review the past literature of rectal EMP.
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Affiliation(s)
- Wataru Miwa
- Division of Internal Medicine, Hiratsuka Gastroenterological Hospital, 3-2-16 Nishiikebukuro, Toshima-ku, Tokyo, 171-0021, Japan.
| | - Takashi Hiratsuka
- Division of Internal Medicine, Hiratsuka Gastroenterological Hospital, 3-2-16 Nishiikebukuro, Toshima-ku, Tokyo, 171-0021, Japan
| | - Shutetsu Tei
- Division of Internal Medicine, Hiratsuka Gastroenterological Hospital, 3-2-16 Nishiikebukuro, Toshima-ku, Tokyo, 171-0021, Japan
| | - Ken Sato
- Division of Surgery, Hiratsuka Gastroenterological Hospital, Tokyo, Japan
| | - Kato Yo
- Department of Pathology, Nikko Medical Center, Dokkyo Medical University, Tochigi, Japan
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Vetro C, Bonanno G, Giulietti G, Romano A, Conticello C, Chiarenza A, Spina P, Coppolino F, Cunsolo R, Raimondo FD. Rare gastrointestinal lymphomas: The endoscopic investigation. World J Gastrointest Endosc 2015; 7:928-949. [PMID: 26265987 PMCID: PMC4530327 DOI: 10.4253/wjge.v7.i10.928] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/01/2015] [Accepted: 07/09/2015] [Indexed: 02/05/2023] Open
Abstract
Gastrointestinal lymphomas represent up to 10% of gastrointestinal malignancies and about one third of non-Hodgkin lymphomas. The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma. However, the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization. Due to their rarity and the multifaceted histology, an endoscopic classification has not been validated yet. This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up, according to the involved site and lymphoma subtype. Existing, new and emerging endoscopic technologies have been examined. In particular, we investigated the diagnostic, prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas, lymphomatous polyposis and mantle cell lymphoma, follicular lymphoma, plasma cell related disease, gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract. Contrarily to more frequent gastrointestinal lymphomas, data about rare lymphomas are mostly extracted from case series and case reports. Due to the data paucity, a synergism between gastroenterologists and hematologists is required in order to better manage the disease. Indeed, clinical and prognostic features are different from nodal and extranodal or the bone marrow (in case of plasma cell disease) counterpart. Therefore, the approach should be based on the knowledge of the peculiar behavior and natural history of disease.
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Solitary plasmacytoma of the cecum and the ascending colon: surgical resection as a treatment modality. Case Rep Surg 2015; 2015:126863. [PMID: 25954564 PMCID: PMC4410540 DOI: 10.1155/2015/126863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 04/02/2015] [Indexed: 02/02/2023] Open
Abstract
Colonic solitary plasmacytoma is a rare disease, with few reports occurring in the literature. Solitary plasmacytoma is defined as a plasma cell tumour with no evidence of bone marrow infiltration. Plasmacytoma can present as a solitary tumour in bone or in other parts of the body. The gastrointestinal tract is rarely the site of the disease. We report on the case of a 51-year-old man presenting with a colonic symptomatic mass with unclear biopsy results. A resected specimen showed a solitary plasmacytoma. Surgical resection was an adequate treatment modality in this case. Endoscopic resection, radiotherapy, and chemotherapy are also preferred treatments in selected gastrointestinal plasmacytoma cases.
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Abstract
Here we report the discovery of an extramedullary ileocecal plasmacytoma, a rare entity reported only ∼60 times in the literature. This finding occurred during management of a patient who had sustained an occult perforation during diagnostic colonoscopy. We explored the patient finding a large ileocecal perforation, and thus a right hemicolectomy was performed. Interestingly, the pathology of the mass was consistent with an extramedullary plasmacytoma, which is a very rare gastrointestinal diagnosis. We end by summarizing the presentation and work-up of extramedullary plasmacytoma.
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Affiliation(s)
- Emmanuel M Gabriel
- Department of Surgery, University of Texas Health Science Center, San Antonio, TX 78229, USA Audie L. Murphy Veterans Affairs Hospital, San Antonio, TX 78229, USA
| | - Michelle Savu
- Department of Surgery, University of Texas Health Science Center, San Antonio, TX 78229, USA Audie L. Murphy Veterans Affairs Hospital, San Antonio, TX 78229, USA
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