{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T03:42:57Z","timestamp":1778989377217,"version":"3.51.4"},"reference-count":13,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,16]],"date-time":"2022-01-16T00:00:00Z","timestamp":1642291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Plasma cell neoplasms are characterized by dysregulated proliferation of mature B cells, which can present with either single (solitary plasmacytoma) or systemic (multiple myeloma (MM)) involvement. MM with extramedullary plasmacytoma (EMP) is a rare disease that accounts for approximately 3\u20135% of all plasmacytomas. EMP with gastrointestinal (GI) system involvement is an even rarer entity, accounting for &lt;1% of MM cases. We present a case of aggressive MM with EMP invading the duodenum, initially presented with massive upper GI hemorrhage and small bowel obstruction. A 67-year-old woman was admitted to our hospital owing to a lack of either gas or feces passage for 3 days. Abdominal distention and vomit with a high coffee ground content were observed for 24 h. The patient\u2019s condition was initially diagnosed as small bowel obstruction, upper gastrointestinal bleeding, severe anemia, acute renal failure, and hypercalcemia. Furthermore, an analysis of immunoelectrophoresis in the blood, bone marrow aspiration, and tissue biopsy supported the diagnosis of MM and EMP invading the duodenum, upper GI hemorrhage, and small bowel obstruction. Our study provided the possible involvement of MM and EMP in the differential diagnosis of patients with unexplained GI hemorrhage and small bowel obstruction. A thorough review of the literature regarding the association between MM, GI hemorrhage, and small bowel obstruction is presented in this study.<\/jats:p>","DOI":"10.3390\/medicina58010134","type":"journal-article","created":{"date-parts":[[2022,1,16]],"date-time":"2022-01-16T20:45:21Z","timestamp":1642365921000},"page":"134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Duodenal Ulcer with Massive Gastrointestinal Hemorrhage as an Initial Manifestation in Multiple Myeloma with Extramedullary Disease: A Case Report"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5005-9508","authenticated-orcid":false,"given":"Hao-Tse","family":"Chiu","sequence":"first","affiliation":[{"name":"Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0280-6417","authenticated-orcid":false,"given":"Po-Huang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao-Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"},{"name":"Division of Colon and Rectal Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wu-Feng","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Hao","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ta-Wei","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Colon and Rectal Surgery, Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,16]]},"reference":[{"key":"ref_1","first-page":"2405","article-title":"Complicated gastrointestinal bleeding of neoplastic diseases of the hematopoietic system","volume":"56","author":"Yoshida","year":"1998","journal-title":"Nihon Rinsho"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1182\/blood-2015-07-635383","article-title":"How I treat extramedullary myeloma","volume":"127","author":"Touzeau","year":"2016","journal-title":"Blood"},{"key":"ref_3","first-page":"2305","article-title":"Extramedullary plasmacytoma: Tumor occurrence and therapeutic concepts","volume":"85","author":"Alexiou","year":"1999","journal-title":"Cancer Interdiscip. 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