Melda CÖMERT, Gülay ALP, Günay SAYDAM, MİNE HEKİMGİL, NAZAN ÖZSAN, Filiz BÜYÜKKEÇECİ

Refrakter myelom seyrinde asit oluşumu ve intraperitoneal deksametazon tedavisine yanıt

Multipl Myelom (MM) plazma hücre klonunun malign proliferasyonu ile karakterize bir plazma hücre diskrazisidir. Asit oluşumu MM'un nadir bir komplikasyonudur ve genellikle karaciğerin plazma hücreleri ile infiltrasyonu sonucu meydana gelen portal hipertansiyona bağlıdır. Asit nadiren peritonun plazma hücre infiltrasyonu sonucu da görülebilir. Myelom seyrinde asit oluşumu progresif seyreder ve yüksek doz kemoterapiye refrakterdir. Peritoneal infiltrasyona bağlı masif asit ile başvuran ve intraperitoneal deksametazon tedavisine yanıt veren bir refrakter myelom olgusu sunulmaktadır

Ascites formation in the course of refractory myeloma and response to intra-peritoneal dexametasone treatment

Multiple myeloma (MM) is a plasma cell dyscrasia characterized by the malignant proliferation of a plasma cell clone. Ascites is a rare complication of MM and generally occurs because of portal hypertension due to the infiltration of liver by plasma cells. Infrequently, ascites is detected as a result of peritoneal infiltration by plasma cells. Ascites in the course of myeloma has a progressive course and is refractory to high dose chemotherapy. A refractory myeloma case with massive ascites due to peritoneal infiltration and responding to intra-peritoneal dexametasone treatment is presented.

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1. Smith A, Howell D, Patmore R, Jack A, Roman E. Incidence of haematological malignancy by sub-type: A report from the Haematological Malignancy Research Network. Br J Cancer 2011;105(11):1684-92.
2. Birjawi GA, Jalbout R, Musallam KM, Tawil AN, Taher AT, Khoury NJ. Abdominal manifestations of multiple myeloma: A Retrospective radiologic overview. Clin Lymphoma Myeloma 2008;8(6):348-51.
3. Sasser RL, Yam LT, Li CY. Myeloma with involvement of the serous cavities. Cytologic and immunochemical diagnosis and literature review. Acta Cytol 1990;34(4):479-85.
4. Damaj G, Mohty M, Vey N, et al. Features of extramedullary and extraosseous multiple myeloma: A report of 19 patients from a single center. Eur J Haematol 2004;73(6):402-6.
5. Young P, Finn BB, Pellegrini D, et al. Myelomatous ascites. An Med Interna 2008;25(2):85-9.
6. Bank H, Liberman SI. Sister Joseph’s nodule and malignant ascites in multiple myeloma. N Engl J Med 1971;284(12):676-7.
7. Khoddami M, Esphehani FN, Aslani FS. Ascites as a presenting feature of relapsed multiple myeloma: Report of a case diagnosed by aspiration cytology. Acta Cytol 1992;36(3):325-8.
8. Alegre A, Martinez-Chamorro C, Fernandez-Ranada JM. Massive myelomatous ascites responsive to VAD chemotherapy and autologous stem cell transplantation. Bone Marrow Transplant 1999;24(3):343-4.
9. Shimizu M, Tsurumi H, Hara T, Fukutomi Y, Moriwaki H. Multiple myeloma presenting as massive ascites. Rinsho Ketsueki 1999;40(6):515-7.