Solitary extramedullary plasmacytoma of the duodenum and pancreas – A case report and review of the literature

Mile Ignjatović; Mihailo Bezmarević; Snežana Cerović

doi:10.2298/7047

Mile Ignjatović Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Mihailo Bezmarević Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Snežana Cerović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia, Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/7047

Ključne reči: plasmacytoma||, ||plazmocitom, duodenum||, ||duodenum, pancreas||, ||pankreas, intestinal obstruction||, ||creva, opstrukcija, surgical procedures, operative||, ||hirurgija, operativne procedure, postoperative period||, ||postoperativni period, ascites||, ||ascit, treatment outcome||, ||lečenje, ishod,

Sažetak

Uvod. Ekstramedularni plazmocitomi (EMP) su retki tumori koji pripadaju plazmaćelijskim oboljenjima sa retkom lokalizacijom u duodenumu. Prikazali smo bolesnicu sa solitarnim EMPs i zahvatanjem duodenuma i pankreasa uspešno izlečenu hirurškom resekcijom, nakon neuspeha hemioterapije. Prikaz bolesnika. Bolesnica, starosti 55 godina, sa prethodno dijagnostikovanim solitarnim EMP duodenuma i pankreasa primljena je u našu ustanovu nakon neuspeha u lečenju sa tri ciklusa hemioterapije po vinkristin, adriablastin, deksametazon (VAD) protokolu, sa visokom gastrointestinalnom opstrukcijom. Na prijemu, kompjuterizovanom tomografijom abdomena otkriven je tumor u predelu drugog dela duodenuma i uncinatnog nastavka pankreasa, sa potpunom opstrukcijom duodenuma. Intraoperativno, nađen je tumor u predelu drugog dela duodenuma, koji je poticao iz zida duodenuma, sa prečnikom od 7 ´ 5 cm, koji je zahvatao kompletnu cirkumferenciju zida duodenuma dovodeći do sužavanja lumena duodenuma na usku pukotinu sa visokom gastrointestinalnom opstrukcijom. Takođe, nađena je i infiltracija glave pankreasa i uncinatnog nastavka. Primenjena je Viplova procedura, ali se postoperativni tok komplikovao nastankom obilnog hiloznog ascita, što je sanirano četiri dana nakon operacije. Zaključak. Svakog bolesnika sa gastrointestinalnom lokalizacijom EMP trebalo bi posmatrati zasebno, a blagovremeno i adekvatno lečenje može omogućiti lokalnu kontrolu bolesti.

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Solitarni ekstramedularni plazmocitom duodenuma i pankreasa

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