Introduction. The extramedullary plasmacytomas (EMPs) are rare tumors of
plasma cell disorders which are rarely found in the duodenum. We presented a
case of solitary EMPs involving the duodenum and pancreas successfully
treated by surgical resection after failure of chemotherapy. Case report. A
55-year-old female with previously diagnosed solitary EMP of the duodenum was
admitted to our institution after failure of three cycles of vincristine,
adriablastine, dexamethasone (VAD) chemotherapy regimen with an upper
gastrointestinal obstruction. On admission computed tomography of the abdomen
showed tumor in the region of the second part of duodenum and uncinate
process of the pancreas with a complete duodenal obstruction.
Intraoperatively a tumor formation was in the region of the second duodenal
part, originated from the wall of duodenum with the total diameter of 7 x 5 cm, covering the entire circumference of duodenal wall leaded to a narrowing
of duodenal lumen to the thigh gap with an upper gastrointestinal
obstruction. Infiltration in the head of the pancreas and uncinate process were also found. The Whipple?s procedure was performed but postoperative
course was complicated by rapidly refilling chylous ascites which was
resolved 4 days after the surgery. Conclusion. Each patient with
gastrointestinal EMPs should be considered separately and in timely manner,
thus adequate treatment could provide local disease control.
Intestinal malrotation causing chylous ascites in an adolescent: a case report