Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with cranial nerve palsies and roentgenographic evidence of sphenoid sinus destruction present diagnostic problems. Although the presence of local primary neoplasms may be considered first, metastatic disease from distant sites also should be considered. We report on eight patients with metastatic tumors to the sphenoid sinus seen at the Mayo Clinic from 1950 through 1976. Primary sites of the lesions included the breast, thyroid gland, lung, kidney, and prostate (two patients). Metastatic myeloma was seen in two patients. Symptoms resulted from involvement of the structures adjacent to the sphenoid sinus and in all patients included diplopia or decreased visual acuity. In four patients, these ocular symptoms were the first sign of disease, after which a complete general examination disclosed the occult primary sites.
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PMID:Metastatic tumors to the sphenoid sinus. 45 57

Orbital involvement by multiple myeloma is rare and affects older individuals usually. The youngest reported patient in a recent series that cites a median age of 56 years is 30 years of age. The present case involves a 19-year-old pregnant black female subject who complained initially of diplopia and whose presenting sign was proptosis. An extensive medical work-up and electron microscopic study were necessary to establish the diagnosis.
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PMID:Multiple myeloma. Orbital involvement in a youth. 84 87

Orbital involvement by plasmacytic lymphoproliferative disorders is rare. Presented are four cases, with different clinical onsets and courses, demonstrating the diversity of expression of lymphoproliferative plasma cell lesions of the orbit. The first patient presented with a slowly developing palpable mass in the upper and anterior orbit. This localized lesion proved to be a reactive plasma cell proliferation. The second case had a 3-month history of proptosis, diplopia, and droopy eyelid and a pulsatile temporal mass with bone destruction. Results of biopsy and systemic investigations showed a solitary plasmacytoma of bone. In the third case, a patient with a known multiple myeloma for 2 years presented with a progressive osteolytic mass which proved on biopsy to be a plasmacytoma. At the time, she also had other active bone lesions. The fourth case presented as a possible orbital cellulitis in a man with known multiple myeloma for 2 years. He proved to have disseminated myeloma, the orbital infiltrate being secondary to sinus involvement. The differential diagnosis for each case can be quite involved. Each case required a biopsy for an accurate diagnosis in addition to a complete clinical, radiographic, and laboratory workup. The pathologic features of each tumor can be misleading. These will be discussed as well as the use of ancillary diagnostic methods such as electron microscopy and immunohistochemistry to further characterize each lesion. The clinical course and treatment modalities will be discussed.
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PMID:Orbital manifestations of plasmacytic lymphoproliferations. 365 77

Orbital involvement is a rare complication of myeloma usually presenting as unilateral proptosis without pain. A case is reported of a woman with bilateral orbital infiltration without proptosis, who became blind within three months of the onset diplopia. The blindness was due to visual field obstruction, with eyelids covering both corneas; the eyes themselves remained normal. This is the first case of orbital myeloma reported in Australia and only the second case of bilateral primary orbital infiltration with myelomatosis to be reported in the world literature.
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PMID:Multiple myeloma with bilateral orbital infiltration and polyneuropathy. 625 77

The patient described, a 51-year-old woman, had diplopia and cephalgia of two weeks' duration. On admission, the radiologic evaluation revealed a mass in the sphenoid sinus, multiple lesions in the calvarium and a solitary lung mass. Biopsy of the lung mass revealed an atypical plasmacytic infiltration. Laboratory findings confirmed the diagnosis of light-chain myeloma presenting with a pulmonary plasmacytoma and cranial nerve involvement.
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PMID:Acute diplopia and a solitary lung mass: a unique presentation of light-chain myeloma. 869 Jun 28

Cranial and intracranial locations have been rarely reported in multiple myeloma. Their occurrence as a harbinger of multiple myeloma seems to have a particular significance. In this report, we discuss a case of multiple myeloma presenting as parasellar syndrome and cranial nerve palsies. A 75-year-old woman was admitted to the hospital in June, 1994, with a 3-month history of headache and a 3-week history of diplopia and photophobia. Physical examination revealed right third, fourth and sixth cranial nerve palsies. MRI scan demonstrated a homogeneous, voluminous mass, isointense in T1-weighted images with the cerebral parenchyma and hyperintense in T2-weighted images, occupying the sphenoid sinus and extending within the sella turcica and right cavernous sinus. Lying above the mass and apparently separated from it by a thin rim of hypointensity was a normal pituitary gland. X rays revealed destructive changes of the sella turcica. A minimal disturbance of endocrine function together with a radiologically abnormal pituitary fossa indicated that the primary lesion might lie outside the pituitary fossa. A diagnosis of IgG-kappa type multiple myeloma was made by pertinent laboratory studies. She received local radiation to the intracranial mass (50 Gy) and conventional chemotherapy. Sixteen months after the therapy she is in good health.
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PMID:[Multiple myeloma presenting as parasellar syndrome and cranial nerve palsies]. 872 53

The case of a 53-year-old man who developed cavernous sinus syndrome (CSS) four years after being diagnosed as having nonsecretory myeloma is described. He was admitted with diplopia and dull pain over the right infraorbital and zygomatic region in June 1997. The cause of CSS was the intracranial involvement of myeloma, which was diagnosed by fiberscopic biopsy. The results of endocrinologic evaluation were almost normal. The response to radiotherapy and chemotherapy was mild. CSS caused by nonsecretory myeloma is rare and its prognosis is poor. More aggressive chemotherapy with stem cell support may be indicated.
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PMID:Cavernous sinus syndrome associated with nonsecretory myeloma. 1062 40

A 62-year-old woman was admitted to our hospital because of double vision. Bone marrow aspiration revealed normal cellularity with 21.6% atypical plasma cells. Immunoelectrophoresis revealed a monoclonal component of IgG kappa in the patient's serum. Coronal and sagittal cranial MRI images showed a tumor in the clivus behind the sella turcica. The patient was diagnosed as having multiple myeloma complicated by double vision due to compression of the bilateral abducens nerve by a plasmacytoma. VAD therapy consisting of vincristine, doxorubicin and dexamethasone, followed by irradiation of the clivus tumor achieved only a transient therapeutic effect, and the double vision and bone disease worsened. Cranial nerve palsy may be a significant complication of multiple myeloma.
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PMID:[Multiple myeloma complicated by bilateral abducens nerve palsy due to a tumor in the clivus]. 1134 86

A 71-year-old man was thirsty, had bone pains and a double vision. Multiple myeloma with hypercalcemia was diagnosed. One tumour in the clivus turned out to be compressing the left N. abducens.
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PMID:[Diagnostic image (86). A man with thirst and diplopia]. 1201 38

We present the case of an 80-year-old male with an history of multiple myeloma (MM) stage I with extramedullary plasmacytoma of the neck, diagnosed 18 months before and in complete remission after radiation therapy and melphalan-prednisone therapy. He was admitted with signs and symptoms characteristic for cavernous sinus syndrome, including diplopia, exophthalmia, ptosis and orbital pain. Magnetic resonance imaging showed a mass lesion in the cavernous sinus, consistent with relapsing extramedullary plasmacytoma. The patient received palliative radiation therapy and high dose dexamethasone, but treatment failed and the patient died. This case represents one of the few reports of extramedullary plasmacytoma of the cavernous sinus. The development of a clinical presentation of cavernous sinus syndrome in a patient with a history of MM or extramedullary plasmacytoma should raise the suspicion of a plasmacytic involvement of the cavernous sinus.
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PMID:Extramedullary plasmacytoma of the cavernous sinus. 1240 Jun 15


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