Recurrence of solitary extramedullary plasmacytoma affecting both optic nerves: a case report

To present a case of atypically located plasmacytoma recurrence with bilateral involvement of the optic nerves.

A 73-year-old man with diabetes, essential hypertension, and primary hypercholesterolemia presented to our clinic with subjective visual loss in his left eye. The patient had a previous history of solitary extramedullary plasmacytoma in the spinal cord, which was treated with resection surgery at the thoracic T6-T12 levels and curative radiotherapy two years prior. The ophthalmological examination indicated best-corrected visual acuity of 20/50 (0.4 logMAR) in both the right eye (OD) and left eye (OS). Intraocular pressure was normal and fundus examination of the eyes showed edema in the left optic nerve, but no other findings. Magnetic resonance imaging of the brain and orbits showed enhancement in both optic nerves, as in other parts of the central nervous system (CNS).

Plasmacytoma represents a rare form of plasma cell neoplasm. When the condition progresses and affects different sites within the CNS, it is essential to re-evaluate and exclude progression to multiple myeloma and/or other plasma cell neoplasms. Individuals diagnosed with plasmacytoma who complain of visual disturbances should undergo ophthalmologic evaluation.