Title : Rare concurrent intraocular orbital and intracranial plasmacytomas in a veteran with multiple myeloma: A case report
Abstract:
Extramedullary multiple myeloma is a rare and aggressive manifestation of multiple myeloma, with limited cases involving concurrent intraocular, orbital, and intracranial plasmacytomas. We report a 59-year-old female veteran diagnosed with multiple myeloma who presented with worsening visual disturbances in the left eye and best corrected visual acuity of 20/100. Imaging studies identified lesions in the choroid, orbit, and brain. Due to high biopsy risk, a presumptive diagnosis of extramedullary multiple myeloma was made. The lesions were treated with external beam radiation therapy alongside chemotherapy. The choroidal lesion resolved two months after treatment, and the orbital and intracranial lesions resolved three months after treatment. The left eye best corrected visual acuity improved to 20/20. Despite local control and visual improvement, the patient developed radiation retinopathy and systemic disease progression over the subsequent months. This case illustrates the role of combined radiotherapy and chemotherapy in managing extramedullary plasmacytomas, demonstrating the potential for visual recovery while highlighting the need for ongoing surveillance and management of radiation-related complications and systemic disease progression.
