MANDIBULAR PLASMACYTOMA PRESENTING WITH EXTENSIVE ROOT RESORPTION

Abstract

<h3>Clinical Presentation</h3> We report here an unusual case of a 67-year-old female who presented to the Faculty of Dentistry at the University of Toronto (Toronto, Canada) with a primary chief complaint of a 2-month history of dull pain in her left mandibular tooth. Clinical examination revealed percussion sensitivity and buccal palpation tenderness of the mandibular left first molar. Panoramic, intraoral, and cone beam computed tomography (CBCT) imaging showed a well-defined, irregularly shaped osteolytic lesion in the left mandibular body, with directional external root resorption of adjacent teeth. <h3>Differential Diagnosis</h3> The radiologic differential diagnosis of a well-defined osteolytic lesion resulting in extensive, directional external root resorption includes benign neoplasms and cysts. Malignant neoplasms, such as multiple myeloma, would be an unlikely consideration. In this case, the radiologic impression was of a benign neoplasm, in particular, central giant cell granuloma. Ameloblastoma and odontogenic myxoma were also considered. <h3>Diagnosis and Management</h3> A diagnosis of plasmacytoma was made through histopathologic examination. A subsequent systemic workup revealed multiple myeloma. <h3>Discussion and Conclusion</h3> Although the occurrence of root resorption in multiple myeloma is rare, it has been reported in a small number of cases in the literature. The radiologic features of this case are presented to highlight this uncommon presentation.