ANAPLASTIC PLASMACYTOMA OF THE MANDIBLE: A CASE REPORT

Abstract

Anaplastic plasmacytomas (AP) of the gnathic bones are uncommon tumors. An otherwise healthy 67-year-old male patient presented with a 2-year history of an asymptomatic swelling affecting the anterior mandible causing tooth mobility. Imaging exams revealed a destructive well-defined multilocular radiolucency causing cortical expansion and disruption. An incisional biopsy was performed and microscopic examination revealed sheets of medium to large-sized anaplastic cells with abundant cytoplasm, eccentric nuclei, and marked pleomorphism. Immunohistochemical markers showed positivity for CD138 and kappa, and negativity for LCA, AE1AE3, desmin, and lambda. The Ki-67 labeling index was 90%. The final diagnosis was AP of the mandible. The patient's clinical checkup ruled out other bone lesions, confirming the diagnosis of a solitary plasmacytoma. The patient is currently undergoing radiotherapy. Oral pathologists should be aware of AP to avoid erroneous diagnoses when evaluating anaplastic cell proliferations of the gnathic bones in elderly patients. Anaplastic plasmacytomas (AP) of the gnathic bones are uncommon tumors. An otherwise healthy 67-year-old male patient presented with a 2-year history of an asymptomatic swelling affecting the anterior mandible causing tooth mobility. Imaging exams revealed a destructive well-defined multilocular radiolucency causing cortical expansion and disruption. An incisional biopsy was performed and microscopic examination revealed sheets of medium to large-sized anaplastic cells with abundant cytoplasm, eccentric nuclei, and marked pleomorphism. Immunohistochemical markers showed positivity for CD138 and kappa, and negativity for LCA, AE1AE3, desmin, and lambda. The Ki-67 labeling index was 90%. The final diagnosis was AP of the mandible. The patient's clinical checkup ruled out other bone lesions, confirming the diagnosis of a solitary plasmacytoma. The patient is currently undergoing radiotherapy. Oral pathologists should be aware of AP to avoid erroneous diagnoses when evaluating anaplastic cell proliferations of the gnathic bones in elderly patients.