Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 4)
Solitary extramedullary plasmacytoma of the duodenum and pancreas – A case report and review of the literature
Authors:
Mile Ignjatović, Mihailo Bezmarević, Snežana Cerović
Introduction. The extramedullary plasmacytomas (EMPs)are rare tumors of plasma cell disorders which are rarely
found in the duodenum. We presented a case of solitary
EMPs involving the duodenum and pancreas successfully
treated by surgical resection after failure of chemotherapy.
Case report. A 55-year-old female with previously diagnosed
solitary EMP of the duodenum was admitted to our institution
after failure of three cycles of vincristine, adriablastine,
dexamethasone (VAD) chemotherapy regimen with an upper
gastrointestinal obstruction. On admission computed tomography
of the abdomen showed tumor in the region of the
second part of duodenum and uncinate process of the pancreas
with a complete duodenal obstruction. Intraoperatively
a tumor formation was in the region of the second duodenal
part, originated from the wall of duodenum with the total diameter
of 7 5 cm, covering the entire circumference of
duodenal wall leaded to a narrowing of duodenal lumen to
the thigh gap with an upper gastrointestinal obstruction. Infiltration
in the head of the pancreas and uncinate process were
also found. The Whipple’s procedure was performed but
postoperative course was complicated by rapidly refilling chylous
ascites which was resolved 4 days after the surgery.
Conclusion. Each patient with gastrointestinal EMPs should
be considered separately and in timely manner, thus adequate
treatment could provide local disease control.
