Abstract
A 74-year-old man was referred to our hospital for the treatment of hypercalcemia, renal dysfunction and hyperproteinemia together with lumbago. He was finally diagnosed as having multiple myeloma in February 2008. Melphalan and prednisone were administered, and the disease reached a stable condition. In September of the same year, he presented with abdominal pain and fullness. Contrast-enhanced CT revealed marked thickening of the rectal wall, and a mass in the right hepatic lobe. Enteroclysis and colonoscopy showed stricture of the rectum. Upper GI endoscopy showed a submucosal-like lesion with ulceration at the anterior wall of the gastric fundus. Histological examination of the biopsies from these lesions indicated infiltration of myeloma cells. Chemotherapy with bortezomib demonstrated poor efficiency, and the patient died five months later. Many studies have reported that extramedullary multiple myeloma lesions occur chiefly in the liver, the spleen, the kidneys, and the lymph nodes. However, it is comparatively rare in the gut. The sites most frequently involved are the small bowel and the stomach, and multiple lesions occurring simultaneously in two or more sites in the gut as in this case are very rare.
