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Orbital Fat Involvement by Metastatic Multiple Myeloma Mimicking Involutional Lower Eyelid Fat Herniation: A Case
1Department of Ophthalmology, Gazi University Faculty of Medicine, Ankara, Turkey.
Purpose:
To report an unusual presentation of orbital extramedullary plasmacytoma in a patient with multiple myeloma, clinically mimicking involutional lower eyelid fat herniation.
Observations:
A 57-year-old man with a history of multiple myeloma in remission presented with a three-month history of progressive fullness of the right lower eyelid. Clinical examination suggested minimal right-sided hyperglobus and asymmetric lower eyelid fat herniation without signs of inflammation. Orbital computerized tomography revealed a hyperdense anterior inferior orbital mass distinct from surrounding fat. Excisional biopsy demonstrated a plasmacytoma confirmed by immunohistochemistry showing CD138 and kappa light chain positivity. The lesion represented metastatic involvement of multiple myeloma.
Conclusions And Importance:
Orbital metastases of multiple myeloma are rare. This case highlights anterior orbital involvement presenting as apparent involutional lower eyelid fat herniation, a potential diagnostic pitfall. Awareness of this presentation is important when evaluating new eyelid or orbital findings in patients with a history of systemic malignancy.
