Abstract
Purpose: To report on the clinical, imaging and histopathological characteristics of an orbital mass in a patient presenting with unilateral exophthalmos. Methods: Imaging studies revealed a lobulated orbital mass situated in the superlateral quadrant of the orbit with adjacent bony erosion of the sphenoid bone. Fine needle aspiration cytology form the orbit suggested lymphoproliferative disorder. The bone marrow showed increased plasma cells and was positive for CD 138 with Lambda light chain restriction. Serum protein electrophoresis showed IgD lambda monoclonal band, the urine was positive for Bence Jones protein. Skeletal survey confirmed multiple osteolytic lesions. Result: The patient was diagnosed as stage IIIB multiple myeloma with orbital plasmacytoma and transferred under the care of oncologist who started bortizomib based chemotherapy with very good clinical and laboratory response after the second cycle and almost 100% clinical recovery of the eye proptosis. Conclusion: The diagnosis of multiple myeloma should be borne in mind in cases of unilateral proptosis as early diagnosis and treatment can be vision saving in these patients. This can be established with extensive histopathological and biochemical investigations.
Highlights
Multiple myeloma usually presents as a systemic, disseminated disease
The plasma cells frequently proliferate in the bone marrow and invade the adjacent bone resulting in bone pain with associated increase in the levels of paraproteins in serum and urine
Orbital involvement can occur as a solitary plasmacytoma or as a part of systemic involvement in multiple myeloma
Summary
Imaging studies revealed a lobulated orbital mass situated in the superlateral quadrant of the orbit with adjacent bony erosion of the sphenoid bone. Fine needle aspiration cytology form the orbit suggested lymphoproliferative disorder. The bone marrow showed increased plasma cells and was positive for CD 138 with Lambda light chain restriction. Serum protein electrophoresis showed IgD lambda monoclonal band, the urine was positive for Bence Jones protein.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Clinical & Experimental Ophthalmology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
