Optic nerve and dura mater involvement as the first sign of multiple myeloma.
OBJECTIVE
To report a case of optic nerve and dura mater involvement as the first sign of multiple myeloma.


METHODS
Case report.


RESULTS
A 43-year-old woman presented with a headache and decreased vision in both eyes. Ophthalmic examination revealed anterior uveitis and subretinal mass around the optic nerves with accompanying disc edema bilaterally. Magnetic resonance imaging showed dural and optic nerve infiltration with tram-track enhancement in the optic nerve sheath. The diagnosis of multiple myeloma was made as a result of systemic investigations. The patient underwent systemic chemotherapy and cranial radiotherapy. After treatment, the patient's headache disappeared, the papilledema regressed, and the ocular findings improved but complete recovery could not be achieved because of fibrous subretinal tissue and degenerative changes of the optic nerve.


CONCLUSIONS
Neurologic and ophthalmic involvement in multiple myeloma may appear as the first manifestation of disease. The correct diagnosis is important because it can be life-saving.
Department of Ophthalmology, Faculty of Medicine, Ege University, Izmir - Turkey.
Suzan Guven
SG
Yilmaz
Gamze
G
Ture
Mehmet Özgür
MÖ
Zengin
Ekrem
E
Talay
Suleyman
S
Men
D000328:Adult; D004388:Dura Mater / Q000473:pathology*; D005260:Female; D006261:Headache / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000175:diagnosis*; D009101:Multiple Myeloma / Q000175:diagnosis*; D019574:Optic Nerve Neoplasms / Q000175:diagnosis*; D010211:Papilledema / Q000175:diagnosis; D014786:Vision Disorders / Q000175:diagnosis