[Multiple myeloma complicated by bilateral abducens nerve palsy due to a tumor in the clivus]

A 62-year-old woman was admitted to our hospital because of double vision. Bone marrow aspiration revealed normal cellularity with 21.6% atypical plasma cells. Immunoelectrophoresis revealed a monoclonal component of IgG kappa in the patient's serum. Coronal and sagittal cranial MRI images showed a tumor in the clivus behind the sella turcica. The patient was diagnosed as having multiple myeloma complicated by double vision due to compression of the bilateral abducens nerve by a plasmacytoma. VAD therapy consisting of vincristine, doxorubicin and dexamethasone, followed by irradiation of the clivus tumor achieved only a transient therapeutic effect, and the double vision and bone disease worsened. Cranial nerve palsy may be a significant complication of multiple myeloma.