[Orbital involvement in IgD Kappa myeloma]

Area of Science:

• Oncology
• Ophthalmology
• Hematology

Background:

• IgDkappa myeloma is a rare plasma cell neoplasm, representing less than 2% of all multiple myeloma cases.
• Orbital involvement in multiple myeloma is infrequent, occurring in approximately 0.3% of patients.
• This specific subtype, IgD myeloma, may exhibit a predilection for orbital tissue infiltration.

Observation:

• A 67-year-old female presented with diffuse bone pain and right eye ptosis, indicative of advanced disease.
• Investigations confirmed IgD kappa myeloma, with radiological evidence of sphenoid bone destruction in the orbit.
• The patient experienced rapid disease progression despite polychemotherapy.

Findings:

• Orbital IgD myeloma can manifest with symptoms such as ptosis, diplopia, vision loss, and pain.
• The case demonstrated rapid progression leading to death within 17 months due to renal failure and amyloidosis.
• While orbital involvement may not directly impact overall survival prognosis, it can significantly affect functional outcomes.

Implications:

• This case underscores the importance of considering orbital involvement in rare myeloma subtypes.
• Early recognition and management of orbital symptoms in IgD myeloma are crucial for patient care.
• Further research is warranted to understand the specific mechanisms and prognostic implications of orbital IgD myeloma.