Optic Disc Infiltration as a Sign of Multiple Myeloma Recurrence.

IF 1.3 Q4 HEMATOLOGY Journal of hematology Pub Date : 2024-08-01 Epub Date: 2024-08-15 DOI:10.14740/jh1267
Maria Pantelidou, Eleni Dimitriou, Konstantinos Gkontopoulos, Thomas Thomopoulos, Vasiliki Pappa, Sotirios G Papageorgiou, Panagiotis Theodossiadis, Irini Chatziralli
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Abstract

Multiple myeloma is a plasma cell dyscrasia with an age-standardized incidence of 3 - 4 per 100,000 in the Caucasian population. It is the second most common hematological malignancy after non-Hodgkin lymphoma, representing 1% of all cancers. Herein, we present a case report of multiple myeloma with ocular involvement as a sign of recurrence. A 62-year-old woman, with a known history of lambda light chain multiple myeloma, presented with reduced visual acuity in both eyes while on maintenance chemotherapy. The patient also had mild unsteadiness and fatigue. Fundus examination revealed bilateral optic disc swelling and hemorrhages of the posterior pole. Magnetic resonance imaging disclosed no abnormalities. Although no biopsy of the optic nerve was possible, intracranial pressure was elevated and cerebrospinal fluid was riddled with neoplastic cells, affirming the diagnosis. After 2 months of chemotherapy, visual function and the appearance of the posterior pole returned to normal. In cases of multiple myeloma, mechanisms, such as hyperviscosity syndrome, microvascular impairment and optic nerve and meningeal infiltration on a cellular level may have played a pivotal role in the ocular involvement, which can be the first sign of recurrence.

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视盘浸润是多发性骨髓瘤复发的征兆
多发性骨髓瘤是一种浆细胞障碍性疾病,在白种人中的年龄标准化发病率为每 10 万人中 3-4 例。它是仅次于非霍奇金淋巴瘤的第二大常见血液恶性肿瘤,占所有癌症的 1%。我们在此报告一例多发性骨髓瘤眼部受累的复发病例。一名 62 岁的女性患者曾患λ轻链多发性骨髓瘤,在接受维持性化疗期间出现双眼视力下降。患者还伴有轻微的站立不稳和疲劳感。眼底检查发现双侧视盘肿胀,后极部出血。磁共振成像未发现异常。虽然无法对视神经进行活组织检查,但颅内压升高,脑脊液中充满了肿瘤细胞,从而确定了诊断。经过两个月的化疗,视功能和后极外观恢复正常。在多发性骨髓瘤病例中,高粘度综合征、微血管损伤、视神经和脑膜细胞水平的浸润等机制可能在眼部受累中起了关键作用,而眼部受累可能是复发的第一个征兆。
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Journal of hematology
Journal of hematology HEMATOLOGY-
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