A Very Rare Presentation of Multiple Myeloma: Unilateral Raccoon Eye.
Multiple myeloma (MM), the second most common hematological malignancy, is caused by the accumulation of monoclonal plasma cells in bone marrow. It accounts for 10-15% of deaths from hematological malignancies and approximately 2% of deaths from cancer. The median age at presentation is 70 years old. The diagnosis is incidental in 30% of cases. MM is often discovered through routine blood screening with a large gap between the total protein and the albumin levels. Two thirds of patients complain of bone pain, especially lower back pain. MM could be diagnosed after a pathologic fracture occurs in one third of patients. Presentation with symptoms related to hyperviscosity, hypercalcemia and bleeding tendency could also be observed. A rare presentation of MM is peri-orbital ecchymotic lesion (raccoon eye). Here, we report a 64 years old, male patient presented with unilateral raccoon eye and high erythrocyte sedimentation rate (ESR) to internal medicine outpatient. The patient was referred to hematology outpatient and was diagnosed with multiple myeloma.
Sakarya University, Medical Faculty, Internal Medicine, 54000 Sakarya, Turkey.
Ceyhun
C
Varım
Sakarya University Education and Research Hospital, Internal Medicine, 54000 Sakarya, Turkey.
Hasan
H
Ergenc
Sakarya University Education and Research Hospital, Internal Medicine, Hematology, 54000 Sakarya, Turkey.
Mehmet Sevki
MS
Uyanık
Sakarya University Education and Research Hospital, Internal Medicine, 54000 Sakarya, Turkey.
Tezcan
T
Kaya
Sakarya University Education and Research Hospital, Internal Medicine, 54000 Sakarya, Turkey.
Ahmet
A
Nalbant
Sakarya University Education and Research Hospital, Internal Medicine, 54000 Sakarya, Turkey.
Cengiz
C
Karacaer
Sakarya University Education and Research Hospital, Internal Medicine, Hematology, 54000 Sakarya, Turkey.
Cenk
C
Sunu
Sakarya University Education and Research Hospital, Internal Medicine, 54000 Sakarya, Turkey.
Ali
A
Tamer
ecchymotic lesion; erythrocyte sedimentation rate; hematologic malignancies; multiple myeloma; raccoon eye