Orbital multiple myeloma: a diagnostic challenge

BMJ Case Rep. 2017 Aug 7:2017:bcr2017220895. doi: 10.1136/bcr-2017-220895.

Abstract

Orbital involvement in multiple myeloma is unusual. We describe the case of an 85-year-old woman who presented with right eye proptosis, reduced visual acuity and diplopia. Computed tomography showed a lobulated, enhancing soft tissue mass arising from the right greater wing of the sphenoid with intraconal, lacrimal gland and ocular muscle involvement. Histopathology revealed predominantly atypical plasma cells in a background of reactive lymphocytes, with monoclonality towards kappa light chain protein, suggestive of multiple myeloma. This case illustrates the diagnostic imaging challenge of orbital multiple myeloma.

Keywords: Malignant And Benign Haematology; Medical Education; Ophthalmology; Radiology.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Biopsy
  • Brain / diagnostic imaging
  • Diplopia
  • Fatal Outcome
  • Female
  • Humans
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / pathology
  • Orbital Neoplasms / diagnosis*
  • Orbital Neoplasms / pathology
  • Sphenoid Bone / diagnostic imaging
  • Sphenoid Bone / pathology
  • Tomography, X-Ray Computed