Case report. Plasmacytoma presenting as unilateral proptosis

Area of Science:

• Oncology
• Ophthalmology
• Hematology

Background:

• Solitary orbital plasmacytomas are rare plasma cell neoplasms.
• Orbital tumors can present with proptosis and visual disturbances.
• Immunoelectrophoresis is crucial for detecting monoclonal gammopathies.

Observation:

• A 49-year-old man presented with right eye proptosis and a lytic lesion in the frontal bone.
• Imaging revealed an orbital tumor near the optic nerve foramen.
• Immunoelectrophoresis showed a monoclonal elevation of IgG.

Findings:

• Surgical removal confirmed the orbital tumor as a plasmacytoma.
• The patient received local irradiation followed by chemotherapy due to rising IgG levels.
• Treatment resulted in decreased IgG levels and no further skeletal lesions.

Implications:

• This case highlights the importance of considering plasmacytoma in orbital lesions with monoclonal gammopathy.
• Multimodal treatment can be effective for solitary orbital plasmacytomas.
• Monitoring IgG levels is essential for assessing treatment response and detecting recurrence.