Multiple myeloma involving mandible: In an elderly female
C Sreeja1, B Vijayabanu2, D Vijayalakshmi1
1Department of Oral and Maxillofacial Pathology, Adhiparasakthi Dental College, Melmaruvathur, Tamil Nadu, India.
Abstract:
Multiple myeloma (MM) is a malignancy of plasma cell origin. It often has a multicentric origin within the bone. It makes about 1% of all malignancies and 15% of all hematologic malignancies. There is a monoclonal proliferation of abnormal plasma cells in this disease that arise from a single malignant precursor that has undergone uncontrolled mitotic division. These cells in turn produce one type of immunoglobulin light chain, either kappa or lambda. Unifocal, monoclonal proliferation of plasma cells is called plasmacytoma. Hereby, we present a case of a 65-year-old female patient who presented with a swelling of the mandible. The uniform sheets of plasma cells in the histopathology punched out radiolucencies in skull radiograph and the blood picture of anemia and hypercalcemia, confirmed the case as MM.
Insights
Multiple myeloma, a cancer of plasma cells, can manifest as a solitary bone tumor called plasmacytoma. This case highlights a rare mandibular presentation of multiple myeloma.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Multiple myeloma (MM) is a hematologic malignancy originating from plasma cells.
- It accounts for approximately 1% of all cancers and 15% of blood-related malignancies.
- Characterized by monoclonal proliferation of abnormal plasma cells producing a single immunoglobulin light chain (kappa or lambda).
Observation:
- A 65-year-old female presented with a mandibular swelling.
- Histopathology revealed sheets of plasma cells.
- Radiographic examination showed characteristic 'punched-out' bone lesions in the skull.
Findings:
- The patient exhibited anemia and hypercalcemia.
- Combined clinical, radiographic, and histopathological findings confirmed a diagnosis of multiple myeloma.
- The presentation of a unifocal plasmacytoma in the mandible is a rare manifestation.
Implications:
- This case underscores the importance of considering multiple myeloma in the differential diagnosis of mandibular lesions.
- Early recognition and diagnosis are crucial for effective management of multiple myeloma.
- Highlights the diverse clinical presentations of multiple myeloma, extending beyond typical bone marrow involvement.
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