A 56-year-old male with decreased visual acuity (VA) in left eye (LE) and diplopia of 2 months duration.
Upon inspection, left unilateral exophthalmos with restriction of ocular motility was observed.
The VA was 20/20 in right eye and 20/30 in left eye.
The anterior segment biomycosis was normal and funduscopic examination revealed papilledema in the left eye.
Orbito-craneal computed tomography (CAT) showed the presence of osteolytic lesions in the major and minor wing of the left sphenoid bone, and a mass of infratemporal soft tissues extending to the left.
The abdominal CAT scan revealed osteolytic lesions affecting the posterior arch of the fourth rib and the vertebral body of D4 with associated soft tissue mass.
A puncture aspiration with needle (PAAF) of the lesion was performed, and the result was compatible with plasma cell neoplasia.
Serum and urinary proteinogram was normal and bone marrow biopsy was positive, establishing the diagnosis of non-secretory MM.
Treatment was established with local radiotherapy prior to polychemotherapy.
At 3 months, VA in OI was 20/20 and funduscopic examination did not reveal significant findings.
Orbital-craneal TACs and persistent abdominal control showed mild lytic lesions in the previously indicated locations, without associated soft tissue masses.
