Biliary Obstruction due to a Pancreatic Plasmacytoma

Obstructive jaundice, weight loss, and anorexia often raise a concern for pancreatic malignancy. Although pancreatic adenocarcinoma is the most common form of pancreatic cancer, not all pancreatic malignancies are exocrine in origin. With advancement in endoscopic ultrasound with fine needle aspiration, it has become easier to make correct diagnosis. Plasmacytoma of pancreas is a solitary tumor of plasma cells and it can also lead to the same clinical presentations. Immunohistochemistry is required to make the diagnosis of plasmacytoma. However, when there are other systemic manifestations, such as hypercalcemia, renal injury, and anemia, a diagnosis of multiple myeloma should be suspected and confirmed by cytology or biopsy. It is very important to differentiate plasmacytoma from multiple myeloma as the management for each is different. Herein, we describe a case of multiple myeloma presenting as a pancreatic plasmacytoma causing obstructive jaundice.