Gastrointestinal involvement in a patient with multiple myeloma: A case report

Multiple myeloma is a neoplastic proliferation of monoclonal plasma cells. Although usually restricted to the bone marrow, extraskeletal spread in the form of plasmacytomas which represent localized extramedullary collections of malignant plasma cells can occur in a significant number of patients. However, symptomatic gastrointestinal involvement in multiple myeloma is uncommon and overt gastrointestinal haemorrhage from plasmacytomas is rarely reported. We report a case of gastrointestinal bleeding manifested as melaena in a patient with a known diagnosis of multiple myeloma. Endoscopic and radiologic studies revealed multiple gastric plasmacytomas with evidence of recent bleeding as well as duodenal, colonic and hepatic lesions. The patient was managed conservatively with no evidence of recurrent bleeding. The features of gastrointestinal plasmacytomas are also reviewed.