Kanemura N, Tsurumi H, Hara T, Yamada T, Sawada M, Moriwaki H
First Department of Internal Medicine, Gifu University School of Medicine.
Rinsho Ketsueki. 2001 Mar;42(3):218-20.
A 62-year-old woman was admitted to our hospital because of double vision. Bone marrow aspiration revealed normal cellularity with 21.6% atypical plasma cells. Immunoelectrophoresis revealed a monoclonal component of IgG kappa in the patient's serum. Coronal and sagittal cranial MRI images showed a tumor in the clivus behind the sella turcica. The patient was diagnosed as having multiple myeloma complicated by double vision due to compression of the bilateral abducens nerve by a plasmacytoma. VAD therapy consisting of vincristine, doxorubicin and dexamethasone, followed by irradiation of the clivus tumor achieved only a transient therapeutic effect, and the double vision and bone disease worsened. Cranial nerve palsy may be a significant complication of multiple myeloma.
一名62岁女性因复视而入住我院。骨髓穿刺显示细胞成分正常,非典型浆细胞占21.6%。免疫电泳显示患者血清中有IgG κ单克隆成分。冠状位和矢状位头颅MRI图像显示蝶鞍后方斜坡有一个肿瘤。该患者被诊断为多发性骨髓瘤合并因浆细胞瘤压迫双侧展神经导致的复视。由长春新碱、阿霉素和地塞米松组成的VAD疗法,随后对斜坡肿瘤进行放疗,仅取得了短暂的治疗效果,复视和骨病反而加重。颅神经麻痹可能是多发性骨髓瘤的一个重要并发症。