Otologic presentation of multiple myeloma with isolated temporal bone involvement: Diagnostic and therapeutic implications

Abstract

Plasma cell disorder spectrum ranges from the benign plasma cell granuloma to malignant multiple myeloma characterized by the monoclonal proliferation of plasma cells. Multiple myeloma with temporal bone involvement is a rare entity and may present with nonspecific otological symptoms similar to chronic ear disease leading to a diagnostic challenge. Suspicion of multiple myeloma involving temporal bone primarily is difficult, and most of the cases are diagnosed after initial surgical excision. The differential diagnosis includes temporal bone carcinoma and glomus tumor due to similar radiological features. The final diagnosis is, however, made by the histopathological and immunohistochemical analysis. The mainstay of treatment of multiple myeloma is chemotherapy; however, surgical excision of the lesion is warranted in cases of pressure symptoms and intracranial involvement. We present a case who presented with ear canal mass, facial palsy, and cerebellar symptoms and was diagnosed to be a case of multiple myeloma with temporal bone involvement and was treated successfully. He is on regular follow-up for 1 year and remains in complete remission.