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Isaias PHC, Costa FWG, Amorim PHGH, da Silva RADA, Sousa FB, Pereira KMA, Alves APNN, Mota MRL. Beyond the mouth: Uncovering non-secretory multiple myeloma through oral symptoms. Imaging Sci Dent 2024; 54:211-220. [PMID: 38948192 PMCID: PMC11211024 DOI: 10.5624/isd.20230257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/06/2024] [Accepted: 02/14/2024] [Indexed: 07/02/2024] Open
Abstract
Non-secretory multiple myeloma (NSMM) is a rare cancer of plasma cells characterized by the absence of detectable monoclonal M protein in the blood or urine. A 57-year-old woman presented with mandibular pain but without intraoral swelling. Imaging studies revealed multiple osteolytic lesions in her mandible and pronounced root resorption of the left mandibular second molar. Biopsy results showed atypical plasmacytoid cells positive for anti-kappa, CD138, MUM1, and CD79a antibodies, but negative for anti-lambda and CD20. These results were indicative of a malignant plasma cell neoplasm. No abnormalities were revealed by free light chain assay or by serum or urine protein electrophoresis, leading to a diagnosis of NSMM. The patient began chemotherapy in conjunction with bisphosphonate therapy and achieved remission following treatment. This case underscores the critical role of dentists in the early detection and prevention of NSMM complications, as the disease can initially present in the oral cavity.
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Affiliation(s)
- Pedro Henrique Chaves Isaias
- Department of Dental Clinic, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Fábio Wildson Gurgel Costa
- Department of Dental Clinic, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | | | - Fabrício Bitu Sousa
- Department of Dental Clinic, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
- Department of Dentistry, Christus University Center, Fortaleza, Ceará, Brazil
| | - Karuza Maria Alves Pereira
- Department of Dental Clinic, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Mário Rogério Lima Mota
- Department of Dental Clinic, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Thankappan S, Nedumpillil S. Multiple myeloma with oral manifestations as maxillary ulceroproliferative lesion: A case report. J Cancer Res Ther 2023; 19:S1005-S1008. [PMID: 38384103 DOI: 10.4103/jcrt.jcrt_336_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/24/2022] [Indexed: 02/23/2024]
Abstract
ABSTRACT Multiple Myeloma (MM) is the most common malignant neoplasm of bone and can manifest with different clinical features in oral cavity. MM lesions in skull and jaws have characteristic punched out lesions but are often confused with meningioma when they occur in skull as solitary lesions. We report a case of MM that reported in oral cavity for which prompt diagnosis was done, but there were symptoms that persisted for years and a skull lesion that was diagnosed and treated as meningioma before MM was diagnosed from the oral lesions. This is the first case where the patient has been actually treated for meningioma, and then diagnosed with MM after months. In that case, SBP or MM should be included in the differential diagnosis of a dural mass, particularly when a patient is complaining of neurological deficits. Also, the role of oral physician in the diagnosis of MM should be stressed in diagnosis and multidisciplinary management, thus facilitating better clinical outcomes.
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Affiliation(s)
- Simi Thankappan
- Department of Oral Medicine and Radiology, Government Dental College, Calicut, Kerala, India
| | - Sherin Nedumpillil
- Department of Oral Pathology and Microbiology, Government Dental College, Calicut, Kerala, India
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Kamath P, Babu C, Tamgadge A, Pereira T. Multiple myeloma with presentation in the oral cavity. J Oral Maxillofac Pathol 2022; 26:104-107. [PMID: 35571327 PMCID: PMC9106245 DOI: 10.4103/jomfp.jomfp_377_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/25/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022] Open
Abstract
Plasma cell neoplasms may present in the bone as monoclonal gammopathy of undetermined significance, solitary plasmacytoma of bone, multifocal plasma cell neoplasm of bones known as multiple myeloma (MM) and in soft tissues as extramedullary plasmacytoma. MM is a malignant disease of atypical plasma cells characterized by their multifocal proliferation and production of monoclonal immunoglobulins. Often, the initial clinical feature of this disease is subtle and requires trained primary health-care providers to identify this illness and put together a suitable treatment plan. This case report describes a patient with a swelling in the buccal vestibule which on clinical and pathologic investigation turned out to be MM.
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Affiliation(s)
- Pooja Kamath
- Department of Oral and Maxillofacial Pathology, D Y Patil University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Cathy Babu
- Department of Oral and Maxillofacial Pathology, D Y Patil University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Avinash Tamgadge
- Department of Oral and Maxillofacial Pathology, D Y Patil University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Treville Pereira
- Department of Oral and Maxillofacial Pathology, D Y Patil University School of Dentistry, Navi Mumbai, Maharashtra, India
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Narasimhan M, Chinnaswamy R, V Giri GV, Subramani VN. Oral medullary plasmacytoma: Rare case reports. J Oral Maxillofac Pathol 2020; 24:S55-S58. [PMID: 32189906 PMCID: PMC7069149 DOI: 10.4103/jomfp.jomfp_37_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 08/02/2019] [Accepted: 08/26/2019] [Indexed: 11/06/2022] Open
Abstract
Medullary plasmacytoma (MP) or osseous or solitary bone plasmacytoma is a specializing hematopathology lesion typically present with local symptoms, such as pain, paresthesia and pathologic bone fractures as a result of proliferation of plasma cells. The most often involved sites are active hematopoietic long bones and the vertebrae. The clinical course of disease is identical to spectrum of other plasma cell dyscrasias. The diagnostic criteria include punched-out radiolucencies, monoclonal plasma cells and M protein. This lesion should be considered for the differential diagnosis of bone tumors. It is highly radiosensitive although combination modalities of radiation, surgery and chemotherapy have been used in the treatment. The long-term follow-up is essential. We report two rare cases of oral MP with unusual clinical presentation.
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Affiliation(s)
- Malathi Narasimhan
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Ravindran Chinnaswamy
- Department of Oral Maxillofacial Surgery, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - G V V Giri
- Department of Oral Maxillofacial Surgery, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Vijaya Nirmala Subramani
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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