Orbital extramedullary plasmacytoma masquerading as lacrimal gland tumor: A case report

A 66-year-old man presented with worsening left upper eyelid swelling and redness for a week as well as new-onset diplopia and weight loss. Unilateral proptosis and hypoglobus were noted, and extraocular movements were limited. Imaging showed an extraconal mass with globe displacement and bone destr...

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Bibliographic Details
Published in:CLEVER Clinical and Experimental Vision and Eye Research 2023-01, Vol.6 (1), p.19-21
Main Authors: Gushansky, Konstantin, Semlonov, Anastasia, Reich, Ehud
Format: Article
Language:English
Subjects:
Biopsy
Case reports
Chemotherapy
Diabetes
Diplopia
Epistaxis
Exocrine glands
Fractures
Hematology
Multiple myeloma
Ophthalmology
Orthopedics
Pain
Pathology
Sinuses
Systemic diseases
Tomography
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Summary:A 66-year-old man presented with worsening left upper eyelid swelling and redness for a week as well as new-onset diplopia and weight loss. Unilateral proptosis and hypoglobus were noted, and extraocular movements were limited. Imaging showed an extraconal mass with globe displacement and bone destruction. The mass was first suspected lacrinal gland tumor. However, when biopsy results returned normal, a subperiosteal origin was determined following a radiology consult. An urgent biopsy was performed, with notable intraoperative bleeding from the lesion and eroded infiltrated bone. Pathology results were consistent with extramedullary plasmacytoma, and hematological workup was diagnostic of multiple myeloma. The patient was started on systemic chemotherapy. The disease course was complicated by a pathologic humeral fracture, which was treated after patient stabilization. After two cycles of systemic chemotherapy, there was a significant improvement in pain, proptosis, and extraocular movements.
ISSN:2581-656X
DOI:10.15713/ins.clever.99