Gastrointestinal bleeding as an initial manifestation in asymptomatic multiple myeloma: A case report and review of the literature

Abstract

Multiple myeloma (MM) is an uncommon type of malignant hematological neoplasm which, besides primarily involving the bone marrow, has a potent tendency to involve other organs and to present with various clinical manifestations. Involvement of the gastrointestinal (GI) system, particularly presenting with GI hemorrhage, in the course of MM is extremely rare. In the present study, we report a case of a middle-aged male who initially demonstrated GI bleeding and was finally diagnosed with MM. Further laboratory examinations, including analysis of globulin in the blood, bone marrow aspiration and radiogram, supported this diagnosis. This case may promote the possible involvement of plasma cell myeloma in the differential diagnosis of patients with unexplained and refractory GI bleeding. In this study we also present a thorough review of the literature with regard to the association between MM and GI hemorrhage.

Figure 1

H&E staining of bone marrow biopsy section showing clusters of abnormal malignant-appearing plasma cells (magnification, ×100). H&E, hematoxylin & eosin.

Figure 2

Multiple osteolytic bone lesions in the skull.