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Extramedullary Myeloma Eye Socket

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Though rare, there are instances when a diagnosis of multiple myeloma leads to a relapse of extramedullary myeloma in one or both eye sockets.

As we all know, myeloma is a blood cancer found in the bone marrow. Extramedullary disease (6-20%) occurs when plasma cells grow outside of the bone. In the cases discussed below, in the eye socket.

I am a long-term myeloma survivor and MM cancer coach. I can count on two hands the number of MM patients I’ve worked with who have extramedullary disease.

While there are myeloma patients who have thick blood that causes problems, there have been no instances that I know of where thick blood (hyper viscosity) causes extramedullary disease.

What happens when myeloma is growing in a person’s eye socket?

Multiple myeloma growing in a person’s eye socket can lead to several symptoms and complications:
  1. Eye Pain: Myeloma growth in the eye socket can cause significant pain in and around the affected eye.
  2. Visual Disturbances: Depending on the size and location of the myeloma growth, it may lead to visual disturbances such as blurriness, double vision, or even vision loss if it affects the optic nerve.
  3. Proptosis: Myeloma growth can push the eyeball forward, causing a bulging appearance known as proptosis or exophthalmos.
  4. Swelling: The presence of myeloma can cause swelling around the eye socket, leading to discomfort and changes in appearance.
  5. Decreased Eye Movement: As the myeloma enlarges within the eye socket, it can restrict the normal movement of the eye, leading to limited mobility or difficulty in moving the eye in various directions.
  6. Compression of Nearby Structures: As the myeloma grows, it can compress nearby structures such as nerves and blood vessels, leading to additional symptoms such as numbness, tingling, or even vascular complications.
  7. Risk of Secondary Infections: The presence of a tumor can compromise the local immune response, increasing the risk of secondary infections in the eye or surrounding tissues.
  8. Systemic Symptoms: Myeloma growing in the eye socket is typically indicative of advanced disease, and the individual may also experience systemic symptoms associated with multiple myeloma, such as bone pain, fatigue, anemia, and susceptibility to infections.

What treatments are available for extramedullary plasmacytomas?

Extramedullary plasmacytomas (EMPs) are rare tumors composed of plasma cells that occur outside the bone marrow. The treatment of EMPs typically involves a combination of therapies, including:

  1. Radiation therapy: External beam radiation therapy is often the primary treatment for localized EMPs. It aims to destroy the abnormal plasma cells while minimizing damage to surrounding healthy tissues.
  2. Chemotherapy: Chemotherapy may be used for EMPs that are more extensive or have spread to multiple sites. Commonly used chemotherapy agents for plasma cell disorders include drugs like bortezomib, lenalidomide, and dexamethasone.
  3. Surgery: Surgical resection may be considered for EMPs that are localized and accessible. Surgery can help remove the tumor and alleviate symptoms associated with compression of nearby structures.
  4. Immunomodulatory drugs: Drugs such as thalidomide, lenalidomide, and pomalidomide, which have immunomodulatory properties, may be used either alone or in combination with other therapies to treat EMPs.
  5. Stem cell transplantation: In cases where EMPs are part of a systemic plasma cell disorder like multiple myeloma, high-dose chemotherapy followed by autologous stem cell transplantation may be recommended to achieve remission.
  6. Targeted therapy: Emerging targeted therapies, such as proteasome inhibitors and monoclonal antibodies, are being investigated for their efficacy in treating EMPs.
  7. Supportive care: Patients with EMPs may require supportive care measures to manage symptoms such as pain, fatigue, and complications related to the tumor or treatment.

Based on my research of extramedullary myeloma in a person’s eye socket, the challenge for the patient with extramedullary disease in their eye socket, is that the prognosis is poor.

Chemotherapy, radiation and/or surgery in these cases don’t appear to work will at all. That being the case, I would like to suggest antineoplaston therapy from the Burzynski Research Institute (ANP, BRI).

ANP was the therapy that took me from end-stage myeloma to complete remission. This therapy was completely out-of-pocket for me and required several other unique feature.

But ANP took me from end-stage MM to complete remission after I spent approx. 4 years undergoing chemotherapy, surgery and radiation. I tried every FDA approved therapy that was available to me. No dice.

Please don’t misunderstand me. If conventional myeloma treatments offered the myeloma patient experiencing extramedullary lesions in their eye socket any hope at all, I would certainly recommend them.

Have you been diagnosed with one or more extramedullary plasmacytomas in your eye socket? If you’d like to learn more about evidence-based non-conventional therapies such as ANP from the BRI, send me an email-


hang in there,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Orbital Plasmacytoma in an Elderly Patient With Multiple Myeloma

“Abstract- Orbital plasmacytomas are exceedingly rare neoplasms characterized by the proliferation of monoclonal plasma cells in the orbital soft tissues. Their presentation and clinical course can be diverse, making early diagnosis and management challenging. This case report sheds light on one such instance, emphasizing the diagnostic and therapeutic aspects of this uncommon condition. We present an 81-year-old patient with a prior diagnosis of multiple myeloma and bilateral orbital plasmacytomas, highlighting the importance of imaging in diagnosis and management…

Plasmacytoma can be primary or secondary to disseminated multiple myeloma, categorizing it into two distinct groups, i.e., medullary (about 2-5% of all plasma cell neoplasms) and extramedullary (about 3% of all plasma cell neoplasms)…

Case Presentation

An 81-year-old female patient who was diagnosed with multiple myeloma in 2019 presented with a three-month history of double vision, bulging of the right eye globe, restricted eye movement, and headache. On general physical examination, she had a high blood pressure of 160/95 mm Hg, and her pulse rate was 80 b/min.

An ophthalmological examination revealed bilateral diplopia in all quadrants except inferiorly, mild proptosis of the right eye, and pupils that were normal bilaterally.

Subsequently, a CT scan of the brain was advised to evaluate the patient´s symptoms, which revealed well-defined bilateral intra-orbital tumors with homogenous contrast enhancement. No overlying bone erosion or destruction was identified…

A Case Series of Aggressive Orbital Plasmacytomas

Purpose: Orbital plasmacytoma is a tumor of plasma cells located in the orbit, which is uncommon and only accounts for less than 1% of total orbital tumors. Sixty-five percent of orbital plasmacytoma are carrying a diagnosis of multiple myeloma.

Methods: This is a series of two orbital plasmacytoma cases. Both initial complaints were unilateral rapid onset of non-axial proptosis with palpable mass in the superior orbit. The first case was IgA-type multiple myeloma with multiple secondary plasmacytomas diagnosed based on systemic evaluation showing hyperproteinemia, IgA level elevation with free κ-light chains, and multiple destructive osteolytic lesions. The second patient unfortunately died before systemic evaluation was carried out.

Results: Both patients died less than 2 months after diagnosis, underscoring a very poor prognosis. It is important to perform systemic evaluation and appropriate treatment immediately once the diagnosis has been established.

Conclusions:Orbital plasmacytoma is a rare orbital malignancy and is commonly secondary to systemic multiple myeloma. Ophthalmologists should have a high index of suspicion as it has a nonspecific presentation and consider it as one of the differential diagnoses in orbital tumors.”

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