|Year : 1972 | Volume
| Issue : 1 | Page : 28-30
Bilateral orbit plasmacytoma
BS Darbari, NC Bansal, SN Phadke, MM Arora
Department of Pathology, Pt. Jawaherlal Nehru College Raipur and the Department of Ophthalmology, Maharani Hospital, Jagdalpur M.P., India
B S Darbari
Department of Pathology, Pt. Jawaherlal Nehru College Raipur and the Department of Ophthalmology, Maharani Hospital, Jagdalpur M.P.
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Darbari B S, Bansal N C, Phadke S N, Arora M M. Bilateral orbit plasmacytoma. Indian J Ophthalmol 1972;20:28-30
Extrameduilary plasmocytomas are rare. Calborn and Ferris described the plasma cell tumours of nasal and nasopharyngeal mucosa. Similar cases were reported by blacklock and Macartney  . These tumours are described most frequently occurring in the submucous tissues of the upper respiratory and alimentary passages and subcutaneous tissue. Plasmacytomas of buccal cavity, tonsils, larynx and conjunctiva have been reported by Kautlman  . These tumours form single or multiple polypoid masses which project into the neighbouring cavities. They are usually benign and amenable to local removal and irradiation. However occasionally they invade the underlying bone (Stewart and Taylor;  Capell and Mather  ). It may then be ciirhcult to decide whether the growth primarily arose from bone or from mucous membrane. Willis (1960) suggests the possibility of their multifocal origin from bones and submucous tissues in a 64 years old female who had multiple tumours in bones like skulls, vertebrae, ribs, sternum and pelvis as well as in lungs liver, spleen, kidneys, pancreas, thyroid and mucous membrane of the stomach and small intestine. Stout and Kenney  described widespread subcutaneous metastasis of plasmacytoma arising in nasopharynx. Plasma, cells in these tumours are thought to be derivatives of lymphoblasts Schwartz.
Orbital plasmacytoma are rare. Cases have been reported by Bartkowska  and Jain  . We did not across a case of bilateral plasmacytoma of orbit in the literature and wish to report the same as a rarity.
| Case Report|| |
A 30 year old Hindu tribal female came to the Ophthalmic out patient department of Maharani Hospital, Jagdalpur, M. P. supporting up her eyelids with hands. Upper eyelids of both the sides lodged a painless tumour each of the size of a big almond [Figure - 1]. Each of the tumours extended from the lid margin below to the eyebrow above and from inner canthus to the outer canthus across. It involved the lacrymal gland and further extended into the orbit. The overlying skin was free. The growth was mobile, firm and nodular. The eyeballs were pushed to the nasal side and their movements were restricted in the upper and lateral directions. The vision and the fundus oculi were normal. Skigrams of skull, paranasal sinuses and routine blood and urine examination showed no abnormality. Blood VDRL was negative.
The tumour of the left side was enucleated on 7/2/68. It was involving the lacrymal gland and was not well encapsulated. The tumour of the right side was enucleated after a week. It was also not well encapsulated and was adherent to the bone at the superior orbital ridge. The growth was noted encroaching upon the roof of the orbit occupying the lacrymal fossa and down to the floor of the orbit.
Microscopically the sections from both the tumours showed proliferation of the plasma cells [Figure - 2] supported by a connective tissue reticular stroma. Classical as well as atypical type of plasma cells were arranged in sheets at places, being separated by hyaline material which was not amyloid. Russel bodies were absent.
Post operative period was uneventful.
| Comments|| |
The eyelid is a rare site for the plasmacytoma. In the present case the tumours were bilaterally symmetrical probably having a multifocal origin as suggested by Willis  (loc. cit). The tumour extended to the lacrymal glands on either side. However the origin of the tumours from the lacrymal gland is uncertain as was seen in the case of Gould and Ostrov. The tumours were slow growing and attained the foresaid size in eight and a half months. It in interesting to note that the patient was carefree about these growths and got used to see by supporting the eyelids with her hands. The vision was normal in both the eyes.
| Summary|| |
A case of huge bilateral orbital plasmacytoma in a tribal female aged 30 years has been described.
| Acknowledgement|| |
Our grateful thanks are due to Dr. M. V. Sirsat, Chief Pathologist, Tata Cancer Hospital, Bombay for his valuable opinion on the slide and to Dr. P. S. Manjrekar Reader in Pathology, Medical College Jabalpur for his help in Photomicrograph.
| References|| |
Bartkowska, M.: A case of Orbital Plasma-cytoma, Klin. Oczna, 34:265, 1964
Indexed in Index Medicus Vol. 6 No. 3 5-111.
Blacklock, J. W. S. and Macartney, C.: Plasmacytoma of nasopharynx. J. Path & Bact., 35:69, 1932.
Cappel, D. F. and Mathers, R. P.: Plasma-cytoma of the Petrous Temporal Bone and Base of the Skull. J. Laryng & Otol. 50:340, 1935.
Claiborn, L. N. and Ferris, H. W.: Plasma cell tumours of the nasal and nasopharyngeal mucosa. Arch. Surg. 23, 477, 1931.
Goud. L. and Ostrove, R. Extramedullary Myeloma of the Lacrimal gland. Amer. J. Ophthal 60, 1125, 1965.
Jain, B. S.: Solitary Myeloma of the Orbit. Amer J. Ophthal 58, 855. 1964.
Kaufmaun, E.: Pathology for students and Practitioners, Translated by S. P. Reiman, Balenston Co., New York, P. 272 and 675.
Schwartz, Leo : Plasmacytoma upper respiratory tract and oral cavity. A.M.A. Arch. Otolargingo. 60:573, 1954.
Stewart, M. J. and Taylor, A. L.: Observations on Solitary Plasmacytoma, J. Path. & Bact. 35, 541, 1932.
Stout, A. P. and Kenney, F.R.: Primary Palsma cell tumours of the upper air passages and oral cavity, Cancer, 2, 261, 1948.
Willis, R. A.: Pathology of Tumours, Butterworth & Co. London pp 789, 790, 1960.
[Figure - 1], [Figure - 2]