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Multiple myeloma involving the orbit

A M Fay1, M L Leib, K S Fountain

  • 1Orbit and Plastics Service, Edward S. Harkness Eye Institute, New York, NY 10032, USA.

Ophthalmic Plastic and Reconstructive Surgery
|March 26, 1998
PubMed
Summary

Orbital plasmacytoma, a rare multiple myeloma complication, can occur even without high immunoglobulin levels. Early ophthalmic exams are crucial for timely diagnosis and effective treatment of this rare plasma cell malignancy.

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Area of Science:

  • Oncology
  • Ophthalmology
  • Hematology

Background:

  • Multiple myeloma is a plasma cell malignancy frequently causing skeletal damage.
  • Orbital involvement is an uncommon manifestation of multiple myeloma.
  • Established risk factors for orbital plasmacytoma are lacking.

Observation:

  • A rare case of multiple myeloma with orbital involvement is presented, notably without elevated serum immunoglobulins.
  • The patient exhibited kappa light chains in urine protein electrophoresis.
  • Orbital involvement was detected via plain-film roentgenography at initial diagnosis.

Findings:

  • The patient experienced a significant clinical response to external beam radiation therapy.
  • Early detection of orbital plasmacytoma can influence treatment strategies and patient outcomes.

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  • Immunoprotein characteristics may help identify patients at risk for orbital spread.

    • Implications:

    • Thorough ophthalmic examinations are recommended for all multiple myeloma patients at diagnosis.
    • Early identification of orbital plasmacytoma may allow for safer and equally effective treatments.
    • Further research into risk factors associated with immunoglobulin subtypes is warranted.