Orbital Involvement in Multiple Myeloma

Abstract

Purpose: To characterize clinical and radiographic features, management, and outcomes of patients with orbital involvement of multiple myeloma (MM). Methods: A retrospective chart review identified patients with MM and orbital involvement confirmed by histopathology at a single institution between 1995 and 2021. A comprehensive literature review was performed via PubMed to identify all previously reported cases of orbital MM. Results: Retrospective review identified 7 patients (43% male, mean age 68.7 years). Presenting symptoms included proptosis and diplopia. Orbital lesions were primarily located laterally (42.8%) with associated extraocular muscle (57.1%) or lacrimal gland (42.9%) involvement. Five patients (71.4%) had a previous diagnosis of systemic MM. Six patients received chemoradiation (85.7%). All patients had improvement of orbital disease with 2 patients deceased due to disease at follow-up (mean 8.9 months). Literature review identified 111 cases (46.8% male, mean age 58.6 years). 48.6% presented with orbital disease as the first manifestation of systemic MM. Lesions were most commonly located superolaterally (20.2%) with extraocular muscle infiltration (25.2%), lacrimal gland involvement (7.2%), and orbital bony destruction (39.6%). Treatments included chemoradiation, chemotherapy, or radiation alone. Approximately half (51.4%) of patients experienced improvement in orbital disease following treatment, and 48.6% were deceased at follow-up (mean 20.1 months). Conclusions: This study provides a new retrospective study and updated comprehensive literature review regarding orbital MM. Given its poor prognosis, characterization of orbital MM is essential for early diagnosis. Orbital MM is often unilateral, located superolaterally, and may represent the first manifestation of systemic disease. Treatment includes chemotherapy and radiation, which may improve orbital disease; however, the overall prognosis remains poor.

An observation study of the effect of “Internet + Nursing” on psychological status and quality of life of patients with thyroid eye disease

“…[16] It has been indicated that most patients are willing to accept appointment nursing services and are willing to pay the related costs. [17] Some scholars have also pointed out that the readmission rate of patients who participate in the hospital's "Internet + Nursing Platform" for nursing appointments is significantly lower, and the medical cost is lower. [18] Continuous nursing includes the continuation of nursing services and the maintenance of the doctor-patient relationship, and "Internet + Nursing" provides patients with more specialized home care through specialized nursing services from point to point.…”

Localized Recurrence of Multiple Myeloma in the Lacrimal Gland

“…An updated, comprehensive literature review in 2023 identified 111 total cases of orbital involvement of multiple myeloma, of which 8 (7.2%) involved the lacrimal gland. 4 Among orbital structures, the lacrimal gland is rarely affected. 6 Prior reports of lacrimal gland involvement do exist but they notably differ from the case presented here in that the affected patients also demonstrated other sites of disease.…”

“…An updated, comprehensive literature review in 2023 identified 111 total cases of orbital involvement of multiple myeloma, of which 8 (7.2%) involved the lacrimal gland. 4…”

“…5 The orbit, however, is a rare site of multiple myeloma involvement. [2][3][4] In 1972, Rodman and Font 2 attempted to characterize orbital involvement from multiple myeloma, identifying 30 cases globally. In all cases they identified, systemic findings were also noted (e.g., in the blood, urine, bone marrow, or bony lesions).…”

“…1 The orbit, and more specifically the lacrimal gland, is an uncommon site of multiple myeloma involvement. [2][3][4] Here we describe the case of a patient with IgA kappa multiple myeloma status post multiple lines of therapy and presumed to be without evidence of disease who presented with a recurrence of multiple myeloma isolated to the lacrimal gland, a clinical scenario not previously reported.…”