Optic nerve and dura mater involvement as the first sign of multiple myeloma.

PURPOSE: To report a case of optic nerve and dura mater involvement as the first sign of multiple myeloma.

METHODS

Case report.

RESULTS

A 43-year-old woman presented with a headache and decreased vision in both eyes. Ophthalmic examination revealed anterior uveitis and subretinal mass around the optic nerves with accompanying disc edema bilaterally. Magnetic resonance imaging showed dural and optic nerve infiltration with tram-track enhancement in the optic nerve sheath. The diagnosis of multiple myeloma was made as a result of systemic investigations. The patient underwent systemic chemotherapy and cranial radiotherapy. After treatment, the patient's headache disappeared, the papilledema regressed, and the ocular findings improved but complete recovery could not be achieved because of fibrous subretinal tissue and degenerative changes of the optic nerve.

CONCLUSIONS

Neurologic and ophthalmic involvement in multiple myeloma may appear as the first manifestation of disease. The correct diagnosis is important because it can be life-saving.