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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.