Marginal resection of solitary plasmacytoma in the anterior region of the mandible and dental implant rehabilitation: Report of an unusual case.

Katheleen Miranda Dos Santos,Rafaela Scariot,Cibele Cândida De Almeida Kintopp,Allan Fernando Giovanini,Jennifer Tsi Gerber,Leandro Eduardo Klüppel,Pedro Teruo Mendes Okazaki

doi:10.1016/j.amsu.2018.10.028

Abstract

IntroductionPlasmacytoma describes a neoplastic proliferation of plasma cells affecting different groups of patients according to location, and may demonstrate heterogeneous tumor progression and survival rate. The present article describes a case of solitary plasmacytoma in the mandible.Presentation of caseA 57-year-old male smoker was referred to the oral and maxillofacial service with extensive injury, approximately 4–5 cm in size, involving the anterior inferior region of mandible. After confirming diagnosis of plasmacytoma through incisional biopsy, because it was a recurrent lesion, excision of the lesion was performed through marginal resection of the mandible under general anesthesia. During the same surgical procedure, a 2.4-mm system fixation plate was placed to mitigate the risk for pathological fracture of the mandible. In a second surgery, a region in the base of the mandible was rehabilitated using implants and prosthesis.ConclusionThe patient is currently undergoing clinical and radiological follow-up of 2 years with success.

Highlights

Plasmacytoma describes a neoplastic proliferation of plasma cells affecting different groups of patients according to location, and may demonstrate heterogeneous tumor progression and survival rate
Plasmacytoma is a pathological condition involving neoplastic proliferation of monoclonal plasma cells that commonly involves bone tissue [1,2]. This peculiar disease is usually classified according to its location and is termed solitary plasmacytoma (SP) when it has a single bone involvement, or multiple myeloma when it is polyostotic
It is noteworthy that when localized monoclonal proliferations of plasma cells occur, its progression to multifocal disseminated disease and multiple myeloma appears to be a common event―approximately 80% of cases―and, under these circumstances, the disease represents the most important, most severe and common plasma cell dyscrasia [4,5]

Summary

Introduction

Plasmacytoma is a pathological condition involving neoplastic proliferation of monoclonal plasma cells that commonly involves bone tissue [1,2]. This peculiar disease is usually classified according to its location and is termed solitary plasmacytoma (SP) when it has a single bone involvement, or multiple myeloma when it is polyostotic. When present in the craniofacial bones, it exhibits radiographic characteristics represented by well-defined areas, with unilocular radiolucency or “punched-out” appearance, similar to multiple myeloma, to ill-defined destructive radiolucencies with ragged borders [8]. The present case report describes the diagnosis and full treatment of SP in the mandible based on clinical, radiographic and histological characteristics

Presentation of case

Discussion

Findings

Conclusion