Bilateral Ocular Plasmacytoma Presenting as Anterior Uveitis
Purpose
To report a case of bilateral plasmacytoma presenting as an acute anterior uveitis.
Methods
A case report.
Results
A 64-year-old woman, presented to the ophthalmology outpatient clinic with abrupt onset of severe pain, blurred vision and redness in her right eye. Her medical history is remarkable for multiple myeloma, following bone marrow transplant and recurrent plasma cell leukemia, treated with biologic agent (Kyprolis). Examination revealed severe fibrinous anterior uveitis, accompanied by keratic precipitates, rubeosis iridis, hyphema, and raised intraocular pressure (IOP). The patient was treated intensively with topical steroids, IOP lowering agents, systemic acyclovir and prednisone, along with intracameral tissue plasminogen activator (TPA) injection followed by intra-vitreal bevacizumab injection, with partial improvement. Posterior synechiae, iris bombe and angle closure of 360º developed. An anterior segment ultrasound demonstrated severely thickened iris. Subconjunctival (SC) salmon patch was observed bilaterally. The patient had undergone SC biopsy that showed plasma cells infiltration, suggestive of plasmacytoma. Ruthenium plaque radiotherapy (dose of 40Gy) was initiated and a new cycle of systemic chemotherapy.
Conclusion
Extramedullary plasmacytoma rarely involves ocular structures. In the setting of systemic malignancy, ocular involvement should always be considered, especially when acute inflammation is recalcitrant to therapy.
Conflict of interest
No
Author 1
Last name
SHARON
Initials of first name(s)
Y
Department
Department of Ophthalmology, Rabin Medical Center
City
Petah-Tikva
Country
Israel
Author 2
Last name
Reich
Initials of first name(s)
E
Department
Department of Ophthalmology, Rabin Medical Center
City
Petah-Tikva
Country
Israel
Author 3
Last name
Hayman
Initials of first name(s)
L
Department
Department of Pathology, Rabin Medical Center
City
Petah-Tikva
Country
Israel
Author 4
Last name
Kramer
Initials of first name(s)
M
Department
Department of Ophthalmology, Rabin Medical Center
City
Petah-Tikva
Country
Israel
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