Abstract
Extramedullary multiple myeloma is an aggressive form of myeloma, with gastrointestinal involvement occurring in less than 5% of cases. We present a 60-year-old man admitted after a syncopal episode. Imaging revealed a large esophageal mass and multiple lytic bone lesions. Biopsy confirmed IgG kappa multiple myeloma without bone marrow involvement. Despite chemotherapy, the disease progressed, and the patient passed away 6 months later. Extramedullary esophageal involvement in the setting of advanced multiple myeloma is rare, with only 2 prior reported cases.