Ocular Surface plasmacytoma

Main Article Content

Marta Domínguez-Bernaus Pau Cid-Bertomeu Felip Vilardell Valentin Huerva

Abstract

Conjunctival plasmacytomas are rare tumours that may be solitary or related with multiple myeloma (MM), a malignant systemic plasma cell neoplasm that tends to metastasize. Plasma cell infiltration of bone marrow and presence of immunoglobulin is characteristic of MM. It may cause extraskeletal spread being the ocular tissue involvement very rare.


We report a case of a 57-year-old male patient affected of a caruncular mass that has increased of volume in the past two months. The patient was previously diagnosed of extramedullar affection of MM and he had no treatment in that moment. An excisional biopsy confirmed the diagnostic of a conjunctival plasmacytoma secondary to MM Immunoglobulin D (IgD). Second line systemic chemotherapy treatment produced total regression.


Ocular surface plasmacytoma is an uncommon entity that has to be suspected in a known myeloma patient with a conjunctival mass growth, including the caruncle. The presence of conjunctival plasmacytoma may be a sign of recurrence and insufficient chemotherapy as showed our case. Therefore, regular ophthalmological examinations should be done to the myeloma patients without any treatment.

Article Details

How to Cite
DOMÍNGUEZ-BERNAUS, Marta et al. Ocular Surface plasmacytoma. Medical Research Archives, [S.l.], v. 10, n. 6, june 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2825>. Date accessed: 27 apr. 2024. doi: https://doi.org/10.18103/mra.v10i6.2825.
Section
Case Reports

References

1. Bradley A, Estes A, Ulrich L, Thomas D, Gay D. Epibulbar plasmacytoma masquerading as subconjunctival hemorrhage in a patient with multiple myeloma. Cornea. 2017;36(2):249-251. doi:10.1097/ico.0000000000001071
2. Tetsumoto K, Iwaki H, Inoue M. IGG-kappa extramedullary plasmacytoma of the conjunctiva and orbit. British Journal of Ophthalmology. 1993;77(4):255-257. doi:10.1136/bjo.77.4.255
3. Burkat CN, Van Buren JJ, Lucarelli MJ. Characteristics of Orbital Multiple Myeloma: A Case Report and Literature Review. Survey of Ophthalmology. 2009;54(6):697-704. doi:10.1016/j.survophthal.2009.04.012
4. Benjamin I, Taylor H, Spindler J. Orbital and conjunctival involvement in multiple myeloma: Report of a case. American Journal of Clinical Pathology. 1975;63(6):811-817. doi:10.1093/ajcp/63.6.811
5. Adkins JW, Shields JA, Shields CL, Eagle RC, Flanagan JC, Campanella PC. Plasmacytoma of the eye and orbit. International Ophthalmology. 1997;20(6):339-343. doi:10.1007/bf00176888
6. Alshomar KM, Altariqi SM, Alrikabi AC, Alkatan HM, Al-Faky YH. Primary extramedullary plasmacytoma of the eyelid conjunctiva – a case report and review of the literature. Annals of Medicine and Surgery. 2020;55:1-4. doi:10.1016/j.amsu.2020.04.028
7. JIANG JINGJING, LIU YONG, WANG FULIN, HUANG YIFEI. An unusual occurrence of solitary extramedullary plasmacytoma in the conjunctiva. Oncology Letters. 2012;4(2):245-246. doi:10.3892/ol.2012.726
8. 8. Ben Artsi E, Barkley MR, Khong JJ, Mckelvie PA, McNab AA, Hardy TG. Multiple myeloma manifesting as an ocular salmon patch – A case report. Orbit. 2019;39(5):379-382. doi:10.1080/01676830.2019.1691608
9. Shields JA, Shields CL. Eyelid, Conjunctival, and Orbital Tumors: An Atlas and Textbook. Philadelphia, PA: Wolters Kluwer; 2016.
10. Zuo Z, Tang Y, Bi C-F, et al. Extraosseous (extramedullary) plasmacytomas: A clinicopathologic and immunophenotypic study of 32 Chinese cases. Diagnostic Pathology. 2011;6(1). doi:10.1186/1746-1596-6-123
11. T. DVV, Hellman S, Rosenberg SA. Plasma cell neoplasms. In: Cancer: Principles and Practice of Oncology. Philadelphia: Lippincott-Raven; 1997.
12. Rodriguez-Abreu D, Bordoni A, Zucca E. Epidemiology of hematological malignancies. Annals of Oncology. 2007;18:i3-i8. doi:10.1093/annonc/mdl443
13. Goldstein DA, Schteingart MT, Birnbaum AD, Tessler HH. Bilateral eyelid ecchymoses and corneal crystals. Cornea. 2005;24(6):757-758. doi:10.1097/01.ico.0000154381.13237.a3
14. Lam LA, Rodger DC. Bilateral macular detachments, venous stasis retinopathy, and retinal hemorrhages as initial presentation of multiple myeloma: a case report. Retin Cases Brief Rep. Fall 2014;8(4):240-4.
15. Multiple myeloma, version 3. In: NCCN Clinical Practice Guidelines in Oncology. Jenkintown, PA: National Comprehensive Cancer Network; 2007.
16. Shields CL, Shields JA. Tumors of the conjunctiva and cornea. Indian Journal of Ophthalmology. 2019;67(12):1930. doi:10.4103/ijo.ijo_2040_19
17. Thuro BA, Sagiv O, Shinder R, et al. Clinical presentation and anatomical location of Orbital Plasmacytomas. Ophthalmic Plastic & Reconstructive Surgery. 2018;34(3):258-261. doi:10.1097/iop.0000000000000939
18. Kottler UB, Cursiefen C, Holbach LM. Orbital involvement in multiple myeloma: First sign of insufficient chemotherapy. Ophthalmologica. 2003;217(1):76-78. doi:10.1159/000068251