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CASE REPORT
Diplopia and proptosis due to isolated lateral rectus plasmacytoma in a patient with multiple myeloma
  1. Norman Saffra1,2,
  2. Farzan Gorgani2,
  3. David Panasci3 and
  4. David Kirsch2
  1. 1 Ophthalmology, Maimonides Medical Center, Brooklyn, New York, USA
  2. 2 Ophthalmology, St. John’s Episcopal Hospital, Far Rockaway, New York, USA
  3. 3 Zwanger-Pesiri Radiology, Lawrence, Kansas, USA
  1. Correspondence to Dr Norman Saffra, eyesitemd{at}gmail.com

Abstract

Orbital involvement of multiple myeloma (MM) is uncommon, with most of those reported cases occurring at the time of initial diagnosis of MM. We present a case of an extramedullary plasmacytoma involving only the right lateral rectus of a patient who had been in disease remission. The patient presented with new-onset diplopia and an abduction deficit of the right eye, with mild proptosis. In light of her past medical history of MM, an orbital MRI was obtained. The MRI demonstrated an isolated finding of eccentric enlargement of the right lateral rectus muscle limited to the muscle belly with sparing of the tendinous insertions, leading to diagnosis of plasmacytoma. Patching of the involved eye to alleviate the symptoms of diplopia was instituted. Chemotherapy was initiated, followed by orbital radiation and stem-cell transplantation for coexisting systemic disease. The orbital symptoms of proptosis and diplopia resolved within 1 month of treatment.

  • ophthalmology
  • CNS cancer
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Footnotes

  • Contributors NS was responsible for discussing, planning, conducting, reporting, conception and design, acquisition of data, analysis, and interpretation of data. FG was responsible for discussing, planning, reporting, conception and design, acquisition of data, analysis, and interpretation of data. DP was responsible for discussing, reporting, conception and design, acquisition of data, analysis, and interpretation of data. DK was responsible for discussing, planning, conducting, reporting, conception and design, acquisition of data, analysis, and interpretation of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

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

  • Patient consent for publication Next of kin consent obtained.

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