Periorbital ecchymoses as the initial sign in multiple myeloma.

A 61-year-old man with bilateral recurrent periorbital ecchymoses was followed up for 36 months, at which time the diagnosis of multiple myeloma was established. However, in vitro tests of blood coagulation and platelet function gave normal findings. A biopsy specimen of the ecchymotic area showed no evidence of amyloid. Clinical and laboratory evaluation did not suggest another cause. The mechanism of the localized bleeding tendency could not be elucidated.