Extramedullary relapse of multiple myeloma presenting as hematemesis and melena

Abstract

Background: A 60-year-old woman with multiple myeloma relapsed after a good partial response to high-dose chemotherapy (melphalan 200 mg/m2) and autologous stem-cell transplantation, followed by thalidomide and prednisolone maintenance therapy. She presented with hematemesis and melena following salvage chemotherapy with dexamethasone, cyclophosphamide, etoposide, cisplatin, and rescue therapy with single-agent bortezomib. Investigations: Physical examination, laboratory investigations, gastroscopy, 2-[18F]fluoro-2-deoxyglucose-PET (FDG-PET), breast biopsy and histology. Diagnosis: Multifocal extramedullary relapse of multiple myeloma involving the stomach and duodenum.Management High-dose i..