Recurrence of Multiple Myeloma with Soft Tissue Plasmacytoma Presenting as Unilateral Proptosis

Abstract

Proptosis may be an indicator of recurrence of multiple myeloma in patients thought to be in remission.

Secondary Plasmacytoma of The Orbit In A Patient With Refractory Ig G Kappa Multiple Myeloma

“…2 The average age of ocular involvement by plasmacytoma is after 50 years and most common presentation is exophthalmos (42/52, 81%) and interval to development of orbital lesions since the primary diagnosis of MM is average of 18 months. [8][9][10] Our patient with an established diagnosis of MM presented with progressive exophthalmos at the age of 52 years and had orbital involvement approximately 24 months after the primary diagnosis of MM. Superotemporal orbit and extraconal location of the orbit is considered as the common location for MM due to the rich blood supply to the lacrimal gland & extraocular muscles, presence of extensive marrow in orbital bones, and also may be lacrimal system is more prone to metastasis than other orbital sites.…”

Multiple Myeloma of the Orbit

“…Most common clinical presentation includes proptosis, redness, pain, diplopia, and decreased vision. Proptosis was also noted to be a sign of recurrence of multiple myeloma in patients who are though to be in remission [8]. Unilateral involvement of one eye is more common [9].…”

Orbital Plasmacytoma Mimicking an Orbital Abscess

“…1 Secondary orbital plasmacytomas have been reported to be a possible indication of multiple myeloma recurrence. 2,3 In the setting of secondary orbital plasmacytoma occurring as the presenting sign of recurrent multiple myeloma, the tumor can be significant, and has been reported to result Orbital Plasmacytoma Mimicking an Orbital Abscess in no-light-perception vision. 4 Rare presentations of orbital plasmacytomas include mimicking a chalazion, mimicking a lacrimal gland tumor, mimicking dacryocystitis, eyelid ecchymosis, angioedema-like eyelid edema, variable ptosis, fungating eyelid lesions, isolated extraocular muscle infiltration, orbital hemorrhage, Tolosa Hunt syndrome, or orbital cellulitis.…”