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Unusual presentation of more common disease/injury
CASE REPORT
Orbital multiple myeloma: a diagnostic challenge
  1. Evelyn Tai1,
  2. See Khim Sim2,3,
  3. Juhara Haron3,
  4. Wan-Hazabbah Wan Hitam1
  1. 1Department of Ophthalmology, University Sains Malaysia - Health Campus, Kubang Kerian, Malaysia
  2. 2Department of Radiology, Hospital Sultanah Bahiyah, Alor Setar, Malaysia
  3. 3Department of Radiology, University Sains Malaysia - Health Campus, Kubang Kerian, Malaysia
  1. Correspondence to Dr Evelyn Tai, daileid{at}yahoo.com

Summary

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.

  • Radiology
  • Ophthalmology
  • Medical Education
  • Malignant And Benign Haematology

https://doi.org/10.1136/bcr-2017-220895

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    Footnotes

    • Contributors ET and SKS wrote the manuscript. JH and W-HWH reviewed the articles.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.