A rare case report: Extramedullary Plasmacytoma of Duodenum without concomitant Multiple Myeloma, an unusual presentation

Abstract

Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm that arises outside the bone marrow, accounting for only 1% of plasma cell neoplasms. The gastrointestinal (GI) tract is an uncommon site for EMP, with duodenal involvement being extremely rare. We report the case of a 70-year-old female who presented with persistent abdominal pain, nausea, vomiting, and generalized weakness for three months. Upper gastrointestinal endoscopy revealed a bulky duodenal papilla, and biopsy was performed. Histopathological and immunohistochemical evaluation confirmed the diagnosis of extramedullary plasmacytoma. Extensive hematological and biochemical investigations ruled out concomitant multiple myeloma. Due to its rarity, duodenal EMP poses a diagnostic challenge and necessitates a multidisciplinary approach for optimal management. This case highlights the importance of histopathological and immunohistochemical evaluation in diagnosing duodenal plasmacytoma. Due to its rare presentation and nonspecific symptoms, early recognition and differentiation from multiple myeloma are crucial for appropriate treatment.

Keywords: Extramedullary Plasmacytoma; Plasma cell neoplasm; duodenum