Destructive Radiolucent Lesion in the Mandible: First Sign of Multiple Myeloma

Abstract

Multiple myeloma (MM) most commonly affects the skull, vertebrae, and pelvis. The occurrence of a mandibular lesion as the first sign of MM is uncommon. This report describes a case of MM diagnosed because of a mandibular lesion. Woman, 62, presented a mandibular lesion that had developed over the course of 3 months. Panoramic radiography revealed a destructive radiolucent lesion in the right mandibular ramus. The lesion caused rupture of the anterior cortical bone and extended from the retromolar area to the coronoid process. An incisional biopsy was performed. Histopathological examination revealed numerous pleomorphic plasma cells, some with binucleated nuclei. The tumor cells showed lambda light-chain restriction. The patient was reevaluated, and other lesions were observed in the vertebrae, thus establishing the diagnosis of MM. The patient underwent autologous hematopoietic stem-cell transplantation. In conclusion, MM should be considered in the differential diagnosis of destructive mandibular lesions.