EXTENSIVE MANDIBULAR LESION AS A PRIMARY SIGN OF NEOPLASM OF PLASMA CELL ORIGIN: A CASE REPORT

Abstract

A 57-year-old woman complained of jaw pain and presented no swelling on intraoral examination. Imaging examinations showed extensive osteolytic lesions throughout the mandible with signs of manifestation in the maxilla, including the involvement of other bones. Computed tomography revealed several hypodense osteolytic areas with cortical disruption in the left lingual posterior region of the mandible. Moreover, the incisional biopsy showed diffuse and monotonous layers of plasmacytoid cells with different degrees of differentiation. Immunohistochemical analysis showed positivity in plasmacytoid cells for anti-kappa, CD138, MUM1, and CD79a antibodies, and negative results for anti-lambda and CD20. The diagnosis of multiple myeloma was confirmed based on the histopathological and immunohistochemical data along with the imaging finding of diffuse lytic lesions. The patient was referred for further examinations and treatment. She remained under follow-up for six months after the biopsy and manifested a pathological fracture of the left clavicle, probably related to the underlying disease. A 57-year-old woman complained of jaw pain and presented no swelling on intraoral examination. Imaging examinations showed extensive osteolytic lesions throughout the mandible with signs of manifestation in the maxilla, including the involvement of other bones. Computed tomography revealed several hypodense osteolytic areas with cortical disruption in the left lingual posterior region of the mandible. Moreover, the incisional biopsy showed diffuse and monotonous layers of plasmacytoid cells with different degrees of differentiation. Immunohistochemical analysis showed positivity in plasmacytoid cells for anti-kappa, CD138, MUM1, and CD79a antibodies, and negative results for anti-lambda and CD20. The diagnosis of multiple myeloma was confirmed based on the histopathological and immunohistochemical data along with the imaging finding of diffuse lytic lesions. The patient was referred for further examinations and treatment. She remained under follow-up for six months after the biopsy and manifested a pathological fracture of the left clavicle, probably related to the underlying disease.