Visual impairment as the initial presentation in multiple myeloma: a case report and literature review

Background: Multiple myeloma (MM) is a type of blood cancer, which rarely infiltrates the central nervous system (CNS) and lacks specific neurological symptoms. The prognosis is often poor, as the disease progresses rapidly. Herein, we present a rare case of MM with CNS involvement.

Case description: A 53-year-old man was admitted to the Neurosurgery Department, Jinhua Hospital Affiliated to Zhejiang University with initial symptoms of "blurred vision for 3 months accompanied by numbness on the right side of the face for 7 days". Enhanced cranial magnetic resonance imaging revealed a tumor deep in the right temporal bone. During exploratory surgery, the "fleshy" mass was completely removed. Postoperative pathology confirmed a diagnosis of "plasmacytoma with intermediate features". The patient received multiple systematic chemotherapy treatments after surgery in the department of hematology of Jinhua Hospital Affiliated to Zhejiang University. During a 10-month follow-up period, the patient's neurological symptoms improved, and his general condition was considered good.

Conclusions: This report summarizes the clinical features, diagnosis, treatment, and prognosis of a patient with MM involving the CNS and examines the relevant literature. This case may serve as a reference for future clinical treatment and diagnosis. Further research on the pathophysiology of such cases is warranted.