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Hypertensive uveitis in a patient with uveal plasmacytoma

  • Leonardo Lando
    Correspondence
    Correspondence to Leonardo Lando, MD, Princess Margaret Cancer Centre/UHN, 610 University Avenue, Toronto, ON M5G 2M9
    Affiliations
    Ocular Oncology Service, Princess Margaret Cancer Centre/University Health Network

    Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont.
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  • Zeynep Gürsel Özkurt
    Affiliations
    Ocular Oncology Service, Princess Margaret Cancer Centre/University Health Network

    Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont.
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  • Hatem Krema
    Affiliations
    Ocular Oncology Service, Princess Margaret Cancer Centre/University Health Network

    Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont.
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Published:February 22, 2022DOI:https://doi.org/10.1016/j.jcjo.2022.01.022
      A 63-year-old female with IgA kappa myeloma in remission on maintenance therapy with lenalidomide developed a left intraocular pressure of 30 mm Hg, anterior granulomatous uveitis, and an iridociliary amelanotic mass inferiorly (Fig. 1A, inset) that infiltrated the angle from 2–11 o'clock meridians (arrows). The patient previously had been unresponsive to maximum steroid and hypotensive eyedrops. Systemic work-up was negative for infection, inflammation, and myeloma activity. Intralesional aspiration biopsy with immunohistochemistry confirmed plasmacytoma (Fig. 1B). The eye was treated with external beam radiotherapy (20 Gy, 5 fractions), with resulting pressure reduction, resolution of inflammation, and lesion regression (Fig. 1C). Systemic therapy with lenalidomide was continued without ocular relapse for 3 years.
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