Imaginological characterization of multiple myeloma lesions of the jaws through cone-beam computed tomography

Rocha, Thaiza Gonçalves; Feitosa, Édila Figuerêdo; Maiolino, Ângelo; Filho, Roberto Jose Pessoa de Magalhaes; Guedes, Fernando; Torres, Sandra Regina; Visconti, Maria Augusta Portella Guedes

doi:10.1007/s11282-019-00394-1

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…These features may be important to differentiate from cases of multiple myeloma, which more commonly manifest as intrabony lesions. 29 We found that radiological features alone could not reliably differentiate the lymphoma subtypes. Additionally, literature almost always reported high-grade variants of lymphoma affecting the jawbones.…”

Section: Discussionmentioning

confidence: 74%

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Radiological aspects of lymphomas and leukaemias affecting the jaws: A systematic review

Gomes

Lima

Morais-Perdigão

et al. 2023

J Oral Pathology Medicine

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Background: This systematic review aimed to investigate the radiological features of lymphomas and leukaemias affecting the jaws.Methods: A systematic literature review was conducted using the electronic databases of PubMed, Web of Science and Scopus. Articles that contained sufficient radiographic examinations (periapical, panoramic or computed tomography images) for individual cases were included. Additionally, either immunohistochemical or molecular confirmation was required prior to inclusion. Three authors evaluated and described the image quality and radiological features.Results: From an initial 1079 articles screened, 129 cases were included, containing 88 tomographic, 76 panoramic and 26 periapical examinations. The quality of the majority of images was sufficient for evaluation. Diffuse large B-cell lymphoma, Burkitt lymphoma, leukemic infiltration, plasmablastic lymphoma and extranodal Natural killer (NK)/T-cell lymphoma, nasal type were the most common subtypes. Involved teeth presented with mobility in 37.2% of the cases and a provisional diagnosis of inflammatory/infectious dental disease was considered in 49.2% of cases. Computed tomography exams were available for 76% of the cases, with most presented with an osteolytic lesion with ill-defined borders. Periosteal reactions were uncommon. Conclusion:Lymphoma/leukaemia infiltrates of the jaw bones are usually of highgrade subtypes and rarely present with periosteal reactions.

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Section: Discussionmentioning

confidence: 74%

“…Plasmablastic lymphoma bone involvement presented radiologically with poorly demarcated borders, loss of cortical integrity and cortical erosion or destruction, rather than cortical expansion. These features may be important to differentiate from cases of multiple myeloma, which more commonly manifest as intrabony lesions 29 …”

Section: Discussionmentioning

confidence: 99%

Radiological aspects of lymphomas and leukaemias affecting the jaws: A systematic review

Gomes

Lima

Morais-Perdigão

et al. 2023

J Oral Pathology Medicine

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“…Furthermore, differential diagnosis should consider other pathological processes of the maxilla, including ameloblastoma, osteosarcoma, and Paget disease. 3 24 32 33 Ameloblastoma often presents as a slow, painless growth of bone, despite its multilocular appearance and association with tooth resorption. 34 Osteosarcomas range from osteogenic (characterized by a sunburst appearance) to lytic or a combination of both, with potential widening of the periodontal ligament space in cases involving the mandible.…”

Section: Discussionmentioning

confidence: 99%

Beyond the mouth: Uncovering non-secretory multiple myeloma through oral symptoms

Isaias,

Costa,

Amorim

et al. 2024

Imaging Sci Dent

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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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“…Jaw lesions have been reported in 35% of myeloma cases, albeit not as a primary manifestation of the disease [ 4 ]. The body, angle, and ramus of the mandible are the parts most affected [ 5 ]. Myeloma is preceded by monoclonal gammopathy of undetermined significance, and is characterized by hypercalcemia, renal insufficiency, anemia, and bone lesions (CRAB).…”

Section: Introductionmentioning

confidence: 99%

Osteolytic Lesion of the Maxilla in an Undiagnosed Multiple Myeloma Patient Identified Incidentally by Cone Beam Computed Tomography

et al. 2022

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Patient: Female, 65-year-old Final Diagnosis: Multiple myeloma Symptoms: Palatal lesion Medication: — Clinical Procedure: Biopsy and CBCT • laboratory investigations Specialty: Dentistry Objective: Unusual clinical course Background: Multiple myeloma is a hematological malignancy characterized by monoclonal plasma cell proliferation. Jaw lesions are found in nearly 35% of patients with symptomatic myeloma, and lesions occur in the mandible more often than in the maxilla. However, maxillary or mandibular lesions are rarely found as a primary manifestation of the disease. This report describes a case of a 65-year-old Palestinian woman with lytic lesions in the maxilla due to undiagnosed multiple myeloma identified incidentally on cone beam computed tomography (CBCT). Case Report: A 65-year-old Palestinian woman presented to the Oral Maxillofacial Surgery Clinic with an expansion of the maxilla which was initially thought of as an infection. CBCT imaging revealed diffuse osteolytic lesions involving multiple osseous structures. The patient was biopsied. Histopathological examination was suspicious for plasmacytic neoplasm. She was directly referred to the Hematology Department for further laboratory tests. These included complete blood count, liver function test, bone profile, protein electrophoresis, flow cytometry, and bone marrow biopsy, which were performed to confirm the diagnosis of multiple myeloma. The patient was treated with chemotherapy including zoledronic acid, dexamethasone, bortezomib, and cyclophosphamide. She went into remission for a year but unfortunately died 2 years later. Conclusions: Primary myeloma of the maxilla is a rare presentation. The present report illustrates the role of CBCT imaging supported by a multidisciplinary approach to the diagnosis and management of myeloma. Consequently, it is recommended that dental practitioners be aware of radiographic features and possible oral manifestations to avoid any delay in medical intervention.

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Imaginological characterization of multiple myeloma lesions of the jaws through cone-beam computed tomography

Cited by 5 publications

References 34 publications

Radiological aspects of lymphomas and leukaemias affecting the jaws: A systematic review

Radiological aspects of lymphomas and leukaemias affecting the jaws: A systematic review

Beyond the mouth: Uncovering non-secretory multiple myeloma through oral symptoms

Osteolytic Lesion of the Maxilla in an Undiagnosed Multiple Myeloma Patient Identified Incidentally by Cone Beam Computed Tomography

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