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Successful Treatment for Solitary Bone Plasmacytoma of the Maxilla: A Rare Case Report. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.91352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Plasma cell tumors are monoclonal neoplastic proliferation of plasma cells which are divided into three groups: solitary bone plasmacytoma (SBP) and extramedullary plasmacytoma (EMP) which are localized forms, and multiple myeloma (MM) which is the disseminated form. Skull, long bones, and vertebrae are common sites for SBP and its presence in maxillofacial area is rare. There is a possibility that SBP converts to MM and some authors believe that it can be the early stage of MM. Case Presentation: Here, we present a 59-year old male patient with a mass in maxillary bone enlarging after tooth extraction. Cone beam computed tomography (CBCT) confirmed the existence of a poorly defined lesion in the left maxilla. The microscopic evaluation and immunohistochemical studies confirmed the diffuse and monoclonal population of cells, indicating the diagnosis of plasma cell tumor. There was also no evidence of bone marrow involvement in the aspiration. Conclusions: Early and precise diagnosis of SBP is a crucial element to rule out the possibility of MM. It must be kept in mind that there is possibility of recurrence or progression to MM after treatment which can completely change the course of disease, and this emphasizes the importance of regular follow up.
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Solitary Plasmacytoma of the Mandible: Early Diagnosis and Surgical Management. J Craniofac Surg 2019; 30:e411-e413. [PMID: 31299796 DOI: 10.1097/scs.0000000000005397] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Solitary plasmacytoma is an abnormal proliferation of B-lymphoid cells that involves a single bone. It mainly affects the axial skeleton; the jaw localization is a rare condition. The authors present a case of a 70-year-old female patient with a radiolucency of the angle of the mandible later diagnosed as solitary plasmacytoma.
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dos Santos KM, Gerber JT, Mendes Okazaki PT, Cândida de Almeida Kintopp C, Klüppel LE, Giovanini AF, Scariot R. Marginal resection of solitary plasmacytoma in the anterior region of the mandible and dental implant rehabilitation: Report of an unusual case. Ann Med Surg (Lond) 2018; 36:158-161. [PMID: 30479763 PMCID: PMC6240598 DOI: 10.1016/j.amsu.2018.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/24/2018] [Accepted: 10/24/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Plasmacytoma describes a neoplastic proliferation of plasma cells affecting different groups of patients according to location, and may demonstrate heterogeneous tumor progression and survival rate. The present article describes a case of solitary plasmacytoma in the mandible. PRESENTATION OF CASE A 57-year-old male smoker was referred to the oral and maxillofacial service with extensive injury, approximately 4-5 cm in size, involving the anterior inferior region of mandible. After confirming diagnosis of plasmacytoma through incisional biopsy, because it was a recurrent lesion, excision of the lesion was performed through marginal resection of the mandible under general anesthesia. During the same surgical procedure, a 2.4-mm system fixation plate was placed to mitigate the risk for pathological fracture of the mandible. In a second surgery, a region in the base of the mandible was rehabilitated using implants and prosthesis. CONCLUSION The patient is currently undergoing clinical and radiological follow-up of 2 years with success.
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Affiliation(s)
| | - Jennifer Tsi Gerber
- Department of Oral and Maxillofacial Surgery, Universidade Positivo, Curitiba, Brazil
| | | | | | - Leandro Eduardo Klüppel
- Department of Oral and Maxillofacial Surgery, Universidade Positivo, Curitiba, Brazil
- Department of Dental Prosthesis, Universidade Positivo, Curitiba, Brazil
- Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Rafaela Scariot
- Department of Oral and Maxillofacial Surgery, Universidade Positivo, Curitiba, Brazil
- Department of Dental Prosthesis, Universidade Positivo, Curitiba, Brazil
- Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
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Palakshappa SG, Wadhwan V, Bansal V, Kamarthi N. Multiple myeloma presenting as an unhealed extraction socket: Report of a case with brief review of literature. J Oral Maxillofac Pathol 2018; 22:284. [PMID: 30158793 PMCID: PMC6097359 DOI: 10.4103/jomfp.jomfp_70_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Multiple myeloma (MM) is a relatively rare malignant hematological disease, which is characterized by a monoclonal malignant proliferation of plasma cells that causes osteolytic lesions. Maxillofacial presentations in patients with MM are not uncommon, but because the symptoms are varied, it is very difficult to diagnose MM in this region especially in patients with initial oral involvement. Furthermore, maxillofacial manifestations as an initial sign or symptom are scarce. We report a case of a 40-year-old male patient who presented with an unhealed socket in lower left back tooth region for the past 2 months. The panoramic radiograph revealed a multilocular radiolucency. Histopathological examination of the biopsy specimen revealed a malignant hematopoietic neoplasm formed by plasmacytoid cells. Radiographic survey and immunoreactivity for CD 138 and lambda chain antibody further confirmed the diagnosis of MM.
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Affiliation(s)
| | - Vijay Wadhwan
- Department of Oral Pathology and Microbiology, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Vishal Bansal
- Department of Oral and Maxillofacial Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Nagaraju Kamarthi
- Department of Oral Medicine and Radiology, Subharti Dental College, Meerut, Uttar Pradesh, India
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Solitary Plasmacytoma in the Mandible Resembling an Odontogenic Cyst/Tumor. Case Rep Dent 2016; 2016:3629047. [PMID: 28078146 PMCID: PMC5204110 DOI: 10.1155/2016/3629047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/09/2016] [Accepted: 11/17/2016] [Indexed: 01/28/2023] Open
Abstract
A 46-year-old male patient referred to Department of Oral Medicine, with the primary chief complaint of a painless swelling in the right side of mandibular. A panoramic radiograph revealed a well-defined, multilocular radiolucent bony lesion with thin and straight septa in the right side of mandible extending from distal of canine to mesial of third molar. Histological examination showed a solid proliferation of atypical plasmacytoid cells, which was indicative of plasmacytoma. A systemic workup for the final diagnosis was performed to rule out multiple myeloma.
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Fregnani ER, Leite AA, Parahyba CJ, Nesrallah ACA, Ramos-Perez FMDM, Perez DEDC. Mandibular destructive radiolucent lesion: The first sign of multiple myeloma. J Clin Exp Dent 2016; 8:e465-e468. [PMID: 27703618 PMCID: PMC5045697 DOI: 10.4317/jced.52832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 02/10/2016] [Indexed: 12/22/2022] Open
Abstract
The occurrence of a mandibular lesion as the first sign of multiple myeloma (MM) is uncommon. This report describes a case of MM diagnosed because of a mandibular lesion. A 62-year-old woman presented a destructive radiolucent lesion in the right mandibular ramus. The lesion caused rupture of the anterior cortical bone and extended from the retromolar area to the coronoid process. An incisional biopsy was performed. Histopathological examination revealed numerous pleomorphic plasma cells, some with binucleated nuclei. The tumor cells showed kappa light-chain restriction. Bone marrow biopsy showed findings of massive infiltration of neoplastic plasma cells, besides lesions in the vertebrae. The diagnosis of MM was established. The patient underwent autologous hematopoietic stem-cell transplantation. Currently, the patient is under regular follow up after 40 months of initial treatment. In conclusion, MM should be considered in the differential diagnosis of destructive mandibular lesions.
Key words:Mandible, multiple myeloma, radiolucent lesion.
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Affiliation(s)
| | - Amanda-Almeida Leite
- Department of Clinical and Preventive Dentistry, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | | | | | | | - Danyel-Elias-da Cruz Perez
- Department of Clinical and Preventive Dentistry, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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Kucukkurt S, Karan NB, Senguven B, Kahraman S. Solitary plasmacytoma of the mandible: report of two cases. BMJ Case Rep 2016; 2016:bcr-2015-214255. [PMID: 26961559 DOI: 10.1136/bcr-2015-214255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Plasma cell neoplasms (plasmacytoma) are discrete, solitary masses of lymphoid neoplastic proliferations of B cells. Plasmacytomas comprise three groups: multiple myeloma, solitary plasmacytoma (SP) and extramedullary plasmacytoma. SP originates as a clone of transformed malignant plasma cells in the bone marrow. SP of the jaw is a rare condition; therefore diagnosis is quite difficult and often results in misdiagnosis. MM is a lymphoproliferative disease the prognosis of which is worse than SP. SP can progress to MM in a few months to years after diagnosis. In this regard, early diagnosis of the disease is of utmost importance. This article presents two cases of SP diagnosed in the mandible and documented with clinical, radiographic and histological findings.
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Affiliation(s)
- Sercan Kucukkurt
- Department of Oral and Maxillofacial Surgery, Istanbul Aydin University, Istanbul, Turkey
| | - Nazife Begüm Karan
- Department of Oral and Maxillofacial Surgery, Gazi University, Ankara, Turkey
| | - Burcu Senguven
- Department of Oral and Maxillofacial Surgery, Gazi University, Ankara, Turkey
| | - Sevil Kahraman
- Department of Oral and Maxillofacial Surgery, Gazi University, Ankara, Turkey
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Goetze E, Walter C, Kämmerer PW. Osseous plasma cell neoplasm of the mandible for initial diagnosis of multiple myeloma: case report and literature review. J Maxillofac Oral Surg 2015; 14:469-74. [PMID: 25861199 DOI: 10.1007/s12663-014-0688-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Plasmocytoma of the bone represents a variance of plasma cell neoplasms, which often gives hint for systemic affection. A case of a mandibular tumor as first manifestation of multiple myeloma (MM) is presented and discussed with the literature. MATERIALS AND METHODS A 76-year old female with pain and swelling of the right lower jaw was assigned to the hospital. Radiograph showed a lytic tumor at the mandibular condyle and histological analysis gave evidence of a plasma cell tumor with positivity to CD138. In further examinations, elevated immunoglobulin levels in serum and osseous plasma cell infiltration unveiled MM. PubMed-database was searched by "multiple myeloma primary lesion jaw", "multiple myeloma primary manifestation mandible" and "multiple myeloma mandibular lesion" within the last 30 years. RESULTS Together with the current case, 11 reports including 13 patients were found describing mandibular plasmocytoma as first sign for MM. Mean age was 59 years with slight female preference. Initial symptoms were mostly swelling episodes with or without pain. The main radiological presentation was a uni- or multilocular radiolucency. After a mean follow up time of 29 months (stated in 8 cases; standard deviation 50, min: 1, max: 151), 3/8 patients died and in 5/8 cases, signs of progress were seen. CONCLUSION In rare cases, occurrence of plasmocytoma of the mandible is first sign for MM and should always lead to further investigations regarding systemic disease. Simple examinations such as panoramic X-rays can lead to early detection of MM and thereby better prognosis by earlier treatment.
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Affiliation(s)
- E Goetze
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - C Walter
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - P W Kämmerer
- M.R. Ambedkar Dental College and Hospital, Bangalore, India ; Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Schillingallee 35, 18055 Rostock, Germany
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An SY, An CH, Choi KS, Heo MS. Multiple myeloma presenting as plasmacytoma of the jaws showing prominent bone formation during chemotherapy. Dentomaxillofac Radiol 2013; 42:20110143. [PMID: 23520399 DOI: 10.1259/dmfr.20110143] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
A 65-year-old female visited our hospital complaining of a swelling on the left cheek area of 2 years' duration. A panoramic radiograph revealed an ill-defined osteolytic radiolucent bony lesion involving the left mandibular angle, ascending ramus, coronoid process and condylar process. Histological examination showed the mandibular lesion to be a plasmacytoma, and a systemic work-up was obtained to rule out multiple myeloma. Contrast-enhanced CT images showed a well-defined and slightly enhanced round mass on the left ramal area, accompanied by the destruction of the left ramus and posterior maxilla. An (18)F-fluorodeoxy-glucose positron emission tomography CT ((18)F-FDG PET/CT) scan revealed a hypermetabolic mass extending from the left mandible to the left maxillary sinus. The patient had M-protein in serum and urine, plasma cells up to 36.5% on bone marrow biopsy and anaemia as a clinical complication. The patient was diagnosed with multiple myeloma and received chemotherapy with thalidomide, cyclophosphamide and dexamethasone. A PET/CT scan taken 6 months later revealed that the hypermetabolic mass had disappeared and there was remarkable bone formation on the left mandible compared with a previous PET/CT scan. A panoramic radiograph taken 8 months later also demonstrated a prominent bone formation of the affected site. To the best of our knowledge, the current case is the first report of multiple myeloma presenting as plasmacytoma of the mandible with an FDG PET/CT scan. The lesion was solitary at diagnosis, and remarkable bone formation was newly observed on the radiographic examination during chemotherapy.
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Affiliation(s)
- S-Y An
- Department of Oral and Maxillofacial Radiology, Kyungpook National University, Daegu, Republic of Korea
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