A Case Series of Aggressive Orbital Plasmacytomas

IntroductionOrbital 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. We identified two aggressive orbital plasmacytoma cases. Case PresentationsTwo cases include 41-year-old woman and 45-year-old-man. Both initial complaints were unilateral rapid onset of non-axial proptosis with palpable mass at superior orbit, ophthalmoplegia, and decreased visual acuity. Orbital computed tomography (CT) scan showed extraconal solid mass at superior orbit with bone-destructive and intracranial involvement. The first case was IgA type multiple myeloma with multiple secondary plasmacytomas diagnosed based on systemic evaluation showing hyperproteinemia, elevation of IgA level with free kappa-light chains, and multiple destructive lytic lesions in the left orbit and bilateral frontal bone. The second patient, diagnosed as orbital plasmacytoma, unfortunately died before systemic evaluation was carried out. Both patients died less than two months after diagnosis underscoring a very poor prognosis. DiscussionIt is important to perform systemic evaluation and appropriate treatment immediately once the diagnosis has been established. This case series aimed to increase awareness of orbital plasmacytoma existence and consider it as one of the differential diagnosis in orbital tumor.