Nursel YURTTUTAN, Deniz TUNCEL, Buket Tuğan YILDIZ, Şerife ÇÖKLÜ

Kavernöz Sinüs Tutulumu Gösteren Multipl Myelom Hastası

Multipl miyelom plazma hücrelerinin neoplastik proliferasyonuyla seyreden sistemik bir hastalıktır. Multipl miyelomda kavernöz sinüs tutulumu nadirdir. Manyetik rezonans görüntüleme (MRG) ile kavernöz sinüs çok iyi değerlendirebildiği için tutulumun dışlanmasında MRG ile görüntülemenin rolü büyüktür. Yetmiş yedi yaşında kadın hasta olan olgumuz, sol gözde görme bozukluğu ile polikliniğimize başvurdu. Hastanın yapılan nörolojik muayenesinde; sol göz primer pozisyonda içe deviye idi, bilateral sol gözde belirgin dışa bakış, sol gözde ise aşağı bakış kısıtlılığı mevcuttu. Hastanın çekilen beyin MRG’de bilateral frontopariyetal lob sınır saha alanlarında infarkt ile uyumlu olabilecek yamasal ve nodüler sinyaller izlendi ve sol kavernöz sinüste asimetrik kontrastlanmaya neden olan ve genişleyen yumuşak doku lezyonu saptandı. Hasta multipl miyeloma bağlı sol kavernöz sinüs tutulumu olarak değerlendirildi ve hasta onkolojik tedavi aldığı merkeze tedavisinin tekrar değerlendirilmesi için yönlendirildi. Multipl miyelomda kavernöz sinüs tutulumu nadir olduğundan bu hastayı sunmaya değer bulduk.

Kavernöz Sinus Holding Showing Multiple Myelom Patient

Multipl myeloma is a systemic disease with neoplastic proliferation of plasma cells. Cavernous sinus involvement is rare in multipl myeloma. The role of imaging with MRI to exclusion of involvement is great because the cavernous sinus can be evaluated very well by magnetic resonance imaging (MRI). Our case, a seventy seven-year-old female patient, applied to our policlinic with visual disturbance in the left eye. In the neurological examination of the patient; left eye was inside in the primer position, bilateral external view limitation was present marked in the left eye and downward view limitation was present in the left eye. Patient’s brain MRI showed patchy and nodal signals in the frontoparietal lob borderzone area may be compatible with infarct and causing asymmetric enhancement of the left cavernous sinus and expanding soft tissue lesion was detected. The patient was evaluated as multiple myeloma-associated left cavernous sinus involvement and the patient was directed to oncologic treatment center to re-evaluate her oncologic therapy. Since cavernous sinus involvement is rare in multiple myeloma, we found this patient worthy to present.

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