Orbital and muscle involvement in multiple myeloma
François Thoumazet1, Angélique Donnio, Lucas Ayeboua
1Service d'Opthalmologie, Centre Hospitalier Universitaire de Fort de France, France.
Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|January 17, 2007
Summary
Orbital plasmacytoma, a rare complication of multiple myeloma, can involve the eye socket and surrounding sinuses. Immunoglobulin G multiple myeloma may increase the risk of this rare orbital spread.
Area of Science:
- Oncology
- Ophthalmology
- Hematology
Background:
- Multiple myeloma is a plasma cell malignancy with rare extraskeletal manifestations.
- Orbital involvement in multiple myeloma is exceptionally uncommon, with limited case reports in medical literature.
Observation:
- Two cases of orbital plasmacytoma in patients with pre-existing multiple myeloma are presented.
- Case 1 involved orbital spread with secondary maxillary sinus involvement.
- Case 2 details the first reported instance of immunoglobulin A kappa light chain multiple myeloma affecting orbital recti muscles.
Findings:
- Diagnosis was confirmed using computed axial tomography, magnetic resonance imaging, and histopathologic studies.
- Extraskeletal spread of multiple myeloma is rare, with orbital sites being exceedingly uncommon.
- A literature review suggests immunoglobulin G multiple myeloma (lambda or kappa light chain) may be a risk factor for orbital involvement.
Implications:
- Highlights the importance of considering orbital plasmacytoma in patients with multiple myeloma presenting with ocular symptoms.
- Suggests a potential association between specific immunoglobulin types of multiple myeloma and orbital spread.
- Underscores the need for advanced imaging and histopathology for accurate diagnosis of rare orbital lesions in multiple myeloma patients.
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