title: Ocular manifestations of multiple myeloma: three cases and a review of the literature.
abstract: BACKGROUND
  Multiple myeloma is the most common plasma cell tumor; however, ocular plasmacytomas are rare and can appear in almost any structure of the eye. We present 3 cases, including 2 with unique ophthalmic ultrasound images of ocular plasmacytoma.
  
  
  METHODS
  Three patients with ocular manifestations of multiple myeloma are described. All were noted to have known synchronous systemic disease. In this study, patients presented with epibulbar (n = 2), iridociliary (n = 1), and orbital (n = 2) plasmacytomas. Presenting signs included clinically visible tumor (n = 2), blurred vision (n = 2), diplopia (n = 2), and glaucoma (n = 1). The iridociliary plasmacytoma was defined by high-frequency 35-MHz ultrasonography that revealed 360° of anterior chamber involvement, secondary angle-closure, and extent of iridociliary invasion. In another case, low-frequency B-scan ultrasonography found multiple myeloma of the orbit. Ocular manifestations of multiple myeloma, histopathology, treatment, and prognosis are described.
  
  
  CONCLUSIONS
  Ocular manifestations of plasma cell neoplasms are rare. In multiple myeloma, plasmacytomas can present as a solitary tumor, as an initial sign of systemic disease, or as recurrence. This study presents 3 cases in which epibulbar, orbital, and iridociliary plasmacytoma with secondary glaucoma were presenting signs of uncontrolled multiple myeloma.
authors.affiliation: The New York Eye Cancer Center, New York, New York 10065, USA. kchin@eyecancer.com
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Chin
authors.forename: Sanford
authors.initials: S
authors.lastname: Kempin
authors.forename: Tatyana
authors.initials: T
authors.lastname: Milman
authors.forename: Paul T
authors.initials: PT
authors.lastname: Finger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005094:Exophthalmos / Q000209:etiology; D005134:Eye Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D005260:Female; D005901:Glaucoma / Q000209:etiology; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D009389:Neovascularization, Pathologic; D009918:Orbital Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D010954:Plasmacytoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D014463:Ultrasonography; D014604:Uveal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy