A bleeding gastric myeloma: Figure 1

A 91-year-old woman was admitted because of haematemesis and melena and impending haemodynamic impairment. Her past medical history was unremarkable; furthermore the patient was not taking any drugs on a regular basis. On rectal examination, melena was confirmed. The initial laboratory examinations showed a haemoglobin of 7.5 g/litre (normal range 12.5–16). After adequate stabilisation with fluid replacement and red cells concentrates, intravenous omeprazole was started, and she underwent to an urgent esophagogastroduodenoscopy that revealed a gastric large fungating type submucosal polyp with central deep ulceration and with signs of recent …