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Multiple Myeloma Presenting as Exophthalmos and Unilateral Central Retinal Vein Occlusion: A Case Report
以突眼及單側中央性視網膜靜脈阻塞為表現的多發性骨髓瘤病例
摘要
目的：報告一例以突眼及單側中央性視網膜靜脈阻塞為表現的多發性骨髓瘤病例。 方法：病例報告。 結果：一位88歲女性因右眼腫脹數週而求診，病人本身在三個月前開始有下背痛且合併雙側下肢麻木感，突眼計測量結果右眼為18毫米左眼為9毫米，經核磁共振發現右眼眼窩外上方有一3×3.8公分的腫瘤，並經眼窩腫瘤切片，血液及骨髓檢查證實為多發性骨髓瘤，在接受放射線療法五個月後眼窩腫瘤明顯變小卻併發左眼中央性視網膜靜脈阻塞，一週後便因鏈球菌肺炎過世。 結論：多發性骨髓瘤以眼窩腫瘤為表現非常罕見，其發生率約低於1%，因此若是年紀較大的病人因突眼求醫時，若合併全身症狀如虛弱無力，體重減輕，骨頭酸痛等，需將多發性骨髓瘤列入鑑別診斷以便早期診斷並治療。
關鍵字
無資料並列摘要
Purpose: To report a case of multiple myeloma presenting with exophthalmos and central retinal vein occlusion. [Editor: The deleted text immediately to the right was not deleted by me.] syndrome associated with retinitis pigmentosa Method: A case report Results: An 88-year-old female patient complained of fullness sensation on in her right eye for several weeks. Three months before ocular presentation, lower back pain with mild numbness radiatinged to the bilateral lower legs was noted. Exophthalmometry revealed 18-mm and 9-mm in the right and left eye respectively. Magnetic resonance image demonstrated a mass lesion about 3×3.8 cm over the superior-lateral quadrant of the right orbit. Multiple myeloma of the right orbit was diagnosed after orbital tumor biopsy, systemic survey and bone marrow aspiration. After radiotherapy for 5 months, the orbital tumor size decreased but central retinal vein occlusion of the left eye was noted. The patient expired due tofrom Streptococcus pneumonia one week later. Conclusion: Ophthalmic presentations of multiple myeloma are rare and the incidence of multiple myeloma as an orbital tumor had beenis reported to be below 1%. Older patients presents with exophthalmos, with symptoms such as generalized fatigue, weight loss or bone pain on movement, the differential diagnosis of multiple myeloma should be included.
延伸閱讀
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