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Unusual association of diseases/symptoms
Metastatic haematological malignancy presenting as a sellar mass
  1. Maneesh Udiawar1,
  2. Christina Bejnariu2,
  3. Stephen Davies3
  1. 1Centre for Endocrine and Diabetes Sciences, University Hospital of Wales, Cardiff, UK
  2. 2Department of Diabetes and Endocrinology, University Hospital of Wales, Cardiff, UK
  3. 3University of Wales College of Medicine, Cardiff, UK
  1. Correspondence to Dr Maneesh Udiawar, man1210{at}yahoo.com

Summary

A man in his 60s with a history of multiple myeloma diagnosed 6 months previously was referred with a diagnosis of a sellar mass. He reported a 3-month history of headaches associated with double vision which appeared to improve with corticosteroid treatment. An MRI scan revealed a 3.7 cm×3 cm×2.6 cm sellar mass with erosion into the sphenoid sinus and extending to the right cavernous sinus. Pituitary function tests were normal apart from hypogonadotrophic hypogonadism. A diagnosis of plasmacytoma was considered and so transphenoidal biopsy of the sellar lesion was organised, which revealed sheets of mature appearing plasma cells, staining exclusively for κ-light chain immunoglobulins. He was to be started on chemotherapy for the myeloma and radiotherapy for the plasmacytoma. The patient's clinical course was complicated by community-acquired pneumonia and renal failure resulting in his death a month after the diagnosis of plasmacytoma.

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