Bilateral Orbital Plasmacytoma in Multiple Myeloma: a Case Report and Literature Review

Orbital plasmacytoma, a rare but biologically aggressive extramedullary neoplasm associated with multiple myeloma (MM), represents a major diagnostic and therapeutic challenge. This publication presents a representative clinical case of a 55-year-old female patient diagnosed with IgG Lambda multiple myeloma and bilateral orbital plasmacytoma refractory to chemotherapeutic agents. The in-depth analysis of clinical data and the subsequent discussion highlight the characteristic clinical manifestations of exophthalmos, fulminant tumor progression, and the imperative need for a multimodal therapeutic strategy, particularly local palliative irradiation (20 Gy delivered in 5 fractions). This case illustrates the efficacy of this approach in achieving local tumor control and preserving the ocular globe, with a notable reversal of pre-existing blindness. This underscores the imperative for diligent and multidisciplinary therapeutic intervention to maximize functional benefits and minimize the deleterious repercussions of this complication, particularly in immunocompromised subjects.