Bortezomib in treatment of extramedullary plasmacytoma of the pancreas

Hepatobiliary Pancreat Dis Int. 2009 Jun;8(3):329-31.

Abstract

Background: Extramedullary pancreatic plasmacytoma treated with bortezomib is rarely reported.

Methods: We admitted a 53-year-old woman with an asymptomatic mass above the left clavicle for over three months, then an asymptomatic swelling of the pancreas was found. A biopsy on the mass and a fine needle aspiration of the pancreas were performed. The diagnosis of extramedullary plasmacytoma (EMP) was made. The patient was initially treated with combination chemotherapy consisting of vincristine, doxorubicin and dexamethasone (VAD regimen). She progressed to painless jaundice during the chemotherapy. Then she was treated with bortezomib and hyper-dose dexamethasone. As a result, she had a near complete remission.

Results: The data demonstrated that the diagnosis was EMP of the pancreas. The patient responded very well to bortezomib, while failing to respond to the traditional chemotherapy regimen of VAD.

Conclusion: EMP of the pancreas is rare. This case gives evidence for an excellent response of EMP of the pancreas to bortezomib.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents, Hormonal / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Boronic Acids / administration & dosage*
  • Bortezomib
  • Cytarabine / therapeutic use
  • Dexamethasone / administration & dosage*
  • Dexamethasone / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • Humans
  • Middle Aged
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / pathology
  • Plasmacytoma / drug therapy*
  • Plasmacytoma / pathology
  • Pyrazines / administration & dosage*
  • Retreatment
  • Treatment Outcome
  • Vincristine / therapeutic use

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Hormonal
  • Boronic Acids
  • Pyrazines
  • Cytarabine
  • Vincristine
  • Bortezomib
  • Dexamethasone

Supplementary concepts

  • VAD regimen