Maxillary Swelling as the First Evidence of Multiple Myeloma

Multiple myeloma with oral manifestations as maxillary ulceroproliferative lesion: A case report

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.

Mandibular lesion as the first sign of multiple myeloma in a young patient

Multiple myeloma (MM) is a malignant neoplasm characterized by an abnormal intramedullary plasma cell proliferation. It accounts for approximately 10% of all hematologic malignancies. It generally occurs between fourth and seventh decades of life, and it is predominant in male patients. Patients lower than 40 years are considered young, and only very few cases have been reported. We present a rare case of a 27-year-old man whose initial findings of MM were a swelling at the ramus of the mandible.

Can dentists detect multiple myeloma through oral manifestations?

Objective

To review published data on oral manifestations of multiple myeloma.

Methods

An electronic database search was performed of articles published from 1971 to November 2016 in order to identify studies that reported oral manifestations of patients with multiple myeloma. Case reports and case series with oral manifestations of multiple myeloma in English were included in the study. An additional search was performed of the references of the selected articles.

Results

Thirty-seven articles that reported 81 patients with oral manifestations of multiple myeloma were selected: 30 case reports (82%) and seven case series (18%). The most common clinical features in the dental cavity were swelling (65.4%), bone pain (33.3%), paresthesia (27.1%) and amyloidosis lesions (11.1%). Osteolytic lesions detected on imaging exams were reported in the majority of the patients (90.1%) as plasmacytomas or ‘punched-out’ lesions.

Conclusions

Swelling and osteolytic lesions represent the most common clinical and radiographic signs of the jaws relating to multiple myeloma, respectively.