Multiple Myeloma

Baur‐Melnyk, Andrea; D’Anastasi, Melvin

doi:10.1007/174_2011_443

Cited by 2 publications

(2 citation statements)

References 85 publications

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“…17 PET and PET/CT with 18 F-FDG are insensitive to diffuse bone marrow infiltration; however, this technique may help to detect new non-suspected lesions overstaging the Figure 4 A positron emission tomography CT scan reveals a hypermetabolic mass extending from the left mandible to the left maxillary sinus disease, with important implications in treatment, and to assess treatment response in solitary or multiple solid plasma cell tumours which have a high FDG uptake before treatment. [18][19][20][21][22][23][24][25] To the best of our knowledge, the current case is the first report of solitary plasmacytoma of the mandible with an 18 F-FDG PET/CT scan. The initial PET/CT scan confirmed that the lesion was solitary with a maximum standardized uptake value of 3.1.…”

Section: Discussionmentioning

confidence: 99%

Multiple myeloma presenting as plasmacytoma of the jaws showing prominent bone formation during chemotherapy

Ch²,

Ks³

et al. 2013

Dentomaxillofacial Radiology

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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-fluorodeoxyglucose 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. Dentomaxillofacial Radiology ( Keywords: multiple myeloma; plasmacytoma; positron-emission tomography; jaw; bone formation Case reportA 65-year-old female visited our hospital complaining of a swelling on the left cheek area for 2 years. The extraoral examination revealed an asymptomatic expansion on the left cheek area. Intraorally, the involved area showed a soft to fluctuant consistency and was covered by locally ulcerated mucosa. There was no complaint of paraesthesia or anaesthesia. A panoramic radiograph was acquired using an Orthopantomograph ® OP 100D (Instrumentarium Imaging, Tuusula, Finland) and revealed an ill-defined osteolytic radiolucent bony lesion involving the left mandibular angle, ascending ramus, coronoid process and condylar process (Figure 1). It also demonstrated a loss of the inferior border of the left zygomatic process of the maxilla and a soft-tissue shadow around the affected area. The lesion contained septum-like residual bone at the angle of the mandible. An incisional biopsy of the left anterior ramal area was performed under local anaesthesia, during which intra-oral bleeding was not noted. A histopathological examination of the specimen

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Section: Discussionmentioning

confidence: 99%

Multiple myeloma presenting as plasmacytoma of the jaws showing prominent bone formation during chemotherapy

Ch²,

Ks³

et al. 2013

Dentomaxillofacial Radiology

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“…9,12,15 Pancreatic cancer and multiple myeloma present diagnostic challenges in primary care because of their nonspecific symptoms and the limited availability of easy-to-use tests for early detection. 16,17 With the exception of jaundice, which is a presenting symptom in only very few cases, the positive predictive value of other common symptoms of pancreatic cancer is very low. 18 In contrast, symptoms of and diagnostic tests for breast cancer are more specific, so that it is less likely that multiple GP visits occur before referral.…”

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Presentations to general practice before a cancer diagnosis in Victoria: a cross‐sectional survey

Lacey

Bishop

Cross

et al. 2016

Medical Journal of Australia

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The known Most patients diagnosed with cancer had initially consulted a general practitioner about their symptoms. Delayed diagnosis is associated with poorer patient experience and possibly worse clinical outcomes.The new The number of GP visits and the time from symptom onset to seeing a hospital specialist were strongly influenced by cancer type. For example, patients with pancreatic cancer or multiple myeloma were more likely to have visited a GP several times; breast cancer patients were least likely to have done so.The implications Strategies for reducing missed opportunities for diagnosing cancer earlier in general practice are needed. Cancer is the leading cause of disease burden in Australia; 1 by 2020 about 150 000 new cases will be diagnosed each year.2 Most patients diagnosed with cancer had initially consulted a general practitioner about their symptoms; [3][4][5][6] GPs are therefore pivotal in the timely diagnosis of cancer. A systematic review found evidence that longer time to diagnosis is associated with poorer clinical outcomes.7 Delays before cancer diagnosis may be caused by various factors at the patient, general practice and health system levels. 8Patients place great value in having their cancer symptoms recognised early, a priority highlighted by a number of medico-legal claims against GPs about perceived delays.9,10 Multiple prediagnostic consultations with a GP are associated with a more negative patient experience of subsequent cancer-related care. 11The 2010 English Cancer Patient Experience Survey (CPES) examined GP visits preceding a cancer diagnosis, and found large variations between cancer types.12 International research has found that patient characteristics associated with primary care delays include younger age, female sex, belonging to an ethnic minority, and living in a rural area. 5 However, there are few data about GP consultations and factors associated with the amount of time preceding a cancer diagnosis in Australia.Our primary aim was to therefore assess the socio-demographic and clinical factors associated with multiple GP visits by patients subsequently diagnosed with cancer in Victoria. Our secondary aim was to investigate factors associated with the length of the interval between patients first recognising a symptom and their seeing a hospital doctor. MethodsStudy design and setting We undertook a cross-sectional survey in 2013 of patients treated for cancer in five of the member hospitals of the Victorian Comprehensive Cancer Centre (VCCC) that cover the inner city and western suburbs of Melbourne (Peter MacCallum Cancer, Melbourne Health, Royal Women's Hospital, St Vincent's Hospital and Western Health). Data collectionThe study design was based on the English CPES.12,13 The CPES survey instrument was selected as it was cognitively validated and field-tested, and provided opportunities for international comparisons. The postal survey, provided in English, included 76 items, of which 65 assessed patient experience of diagnosis and subsequent care. Responses were ...

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Multiple Myeloma

Cited by 2 publications

References 85 publications

Multiple myeloma presenting as plasmacytoma of the jaws showing prominent bone formation during chemotherapy

Multiple myeloma presenting as plasmacytoma of the jaws showing prominent bone formation during chemotherapy

Presentations to general practice before a cancer diagnosis in Victoria: a cross‐sectional survey

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