Thuro Bradley A, Sagiv Oded, Shinder Roman, Debnam J Matthew, Ozgur Omar, Ng John D, Rootman Daniel, Thomas Sheeba K, Esmaeli Bita
Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
Department of Ophthalmology, State University of New York Downstate Medical Center, Brooklyn, New York.
Ophthalmic Plast Reconstr Surg. 2018 May/Jun;34(3):258-261. doi: 10.1097/IOP.0000000000000939.
To evaluate the clinical and anatomical location of orbital plasmacytomas and assess local control following therapy.
The American Society of Ophthalmic Plastic and Reconstructive Surgery Oncology Database was queried to identify patients diagnosed with orbital plasmacytoma. These patients' records were reviewed for demographic characteristics, clinical and radiologic findings, treatments, and outcomes.
Thirty patients from 4 institutions (24 from MD Anderson Cancer Center, 3 from SUNY Downstate Medical Center, 2 from University of California, Los Angeles, and 1 from Oregon Health and Science University) were identified. Eighteen patients (60%) were diagnosed with multiple myeloma (MM) before and 11 (37%) were diagnosed with MM immediately after orbital plasmacytoma. Based on imaging, 4 distinct anatomical patterns were identified: 1) bony plasmacytoma affecting the superotemporal orbit, epidural space, and temporal fossa (15 patients; 50%); 2) discrete orbital plasmacytoma (7 patients; 23%); 3) infiltrative plasmacytoma either originating from a sinus (4 patients; 13%); or 4) originating from the orbital floor and infiltrating facial soft tissue (4 patients; 13%). Of the 29 patients with available treatment data, 2 had radiation only, 3 had chemotherapy only, 6 had chemoradiation, and 18 had stem cell transplant following chemoradiation (n = 17) or only chemotherapy (n = 1). Following treatment, 10 patients achieved complete and 11 achieved partial responses.
Orbital plasmacytomas were found exclusively in patients with MM diagnosed before or immediately after orbital plasmacytoma. Plasmacytomas can have 4 distinct anatomical patterns of origin. Following treatment, all patients had good to excellent local control of their orbital lesions.
评估眼眶浆细胞瘤的临床及解剖位置，并评估治疗后的局部控制情况。
查询美国眼科整形与重建外科学会肿瘤数据库，以确定诊断为眼眶浆细胞瘤的患者。回顾这些患者的记录，包括人口统计学特征、临床和影像学表现、治疗方法及结果。
确定了来自4家机构的30例患者（24例来自MD安德森癌症中心，3例来自纽约州立大学下州医学中心，2例来自加利福尼亚大学洛杉矶分校，1例来自俄勒冈健康与科学大学）。18例患者（60%）在眼眶浆细胞瘤之前被诊断为多发性骨髓瘤（MM），11例（37%）在眼眶浆细胞瘤之后立即被诊断为MM。基于影像学检查，确定了4种不同的解剖模式：1）累及颞上眼眶、硬膜外间隙和颞窝的骨浆细胞瘤（15例患者；50%）；2）孤立性眼眶浆细胞瘤（7例患者；23%）；3）起源于鼻窦的浸润性浆细胞瘤（4例患者；13%）；或4）起源于眶底并浸润面部软组织的浆细胞瘤（4例患者；13%）。在有可用治疗数据的29例患者中，2例仅接受放疗，3例仅接受化疗，6例接受放化疗，18例在放化疗（n = 17）或仅化疗（n = 1）后接受干细胞移植。治疗后，10例患者达到完全缓解，11例达到部分缓解。
眼眶浆细胞瘤仅在眼眶浆细胞瘤之前或之后立即被诊断为MM的患者中发现。浆细胞瘤可具有4种不同的解剖起源模式。治疗后，所有患者眼眶病变的局部控制情况良好至极佳。
