Abstract
Background. A 59-year-old woman presented to the emergency department with a left rib fracture and was diagnosed with IgA multiple myeloma. The patient underwent autologous bone-marrow transplantation, and 14 months later she developed obstructive jaundice.
Investigations. Serum protein electrophoresis, contrast CT of thorax and abdomen, endoscopic retrograde cholangiopancreatography with endoscopic biopsy and pleural biopsy.
Diagnosis. Extramedullary plasmacytomas at pancreatic head and pleura.
Management. Salvage chemotherapy regimens including bortezomib plus steroid, alkylators plus steroid, bortezomib plus anthracycline and radiotherapy, and combined bortezomib, cyclophosphamide, melphalan and steroid therapy.
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Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.
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Chim, C., Hwang, Y., Pang, C. et al. Restoration of chemosensitivity by bortezomib: implications for refractory myeloma. Nat Rev Clin Oncol 6, 237–240 (2009). https://doi.org/10.1038/nrclinonc.2009.15
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DOI: https://doi.org/10.1038/nrclinonc.2009.15