Spheno-Orbital Plasmacytoma as an Initial Presentation of Multiple Myeloma

Abstract

Intracranial plasmacytoma is a rare neoplasm and a subtype of malignant plasma cell tumor. Most patients with plasma cell tumors are diagnosed with multiple myeloma, but 5%–10% of patients are not. This report includes descriptions of radiologic and clinical findings in a patient with intracranial plasmacytoma. Intracranial extra-axial plasmacytomas can be easily misdiagnosed as meningioma in radiologic and clinical findings. A 69-year-old woman presented with exophthalmos and diplopia, and MRI indicated meningioma. Thus, she underwent gross total resection, and her pathologic diagnosis was plasmacytoma. Exophthalmos and diplopia were fully recovered. She was finally diagnosed with multiple myeloma based on systemic evaluation and treated with targeted chemotherapy. MRI conducted at 3 months after surgery showed no local recurrence or remnant tumor. Although intracranial plasmacytomas are difficult to distinguish from meningiomas in preoperative evaluation, gross total resection is recommended for the same purposes as meningiomas. If the pathologic diagnosis is a plasmacytoma, it is essential to have a systemic evaluation for multiple myeloma.

Orbital Plasmacytoma in an Elderly Patient With Multiple Myeloma

“…One distinctive characteristic of orbital plasmacytomas is their capacity to induce bone destruction. Imaging reveals this as erosive changes in the adjacent orbital bones, representing an essential distinguishing factor from other orbital tumors [2][3][4].…”

Successful Treatment of Refractory Orbital Plasmacytoma with Chimeric Antigen Receptor T Cell Therapy: A Case Report and Review of the Literature

“…Chimeric antigen receptor T cell (CAR-T) therapy is typically reserved for refractory disease. Of all reported cases of orbital plasmacytoma secondary to MM, [2][3][4][5][6][7][8][9] only 1 case was treated with CAR-T therapy, with a limited description of the patient's clinical course. 10 Herein the authors describe a case of refractory orbital plasmacytoma successfully treated with CAR-T therapy and review the literature on this novel treatment.…”