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Mandible-Maxilla Multiple Myeloma
Lisa J. Koenig, BChD, DDS, MS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Multiple myeloma (MM)
            • Synonyms

              • Plasmacytoma
              • Plasma cell myeloma
              • Myeloma
            • Definitions

              • Monoclonal malignant proliferation of plasma cells
                • Solitary plasmacytoma is localized form
              • MM is most common malignancy of bone in adults

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Choi WS et al: Medication-related osteonecrosis of the jaw: a preliminary retrospective study of 130 patients with multiple myeloma. Maxillofac Plast Reconstr Surg. 39(1):1, 2017
                                        2. Kitagawa J et al: Efficacy and safety of denosumab in multiple myeloma. Rinsho Ketsueki. 57(5):592-6, 2016
                                        3. Kucukkurt S et al: Solitary plasmacytoma of the mandible: report of two cases. BMJ Case Rep. 2016, 2016
                                        4. Moura LB et al: Pathologic mandibular fracture as first sign of multiple myeloma. J Craniofac Surg. 27(2):e138-9, 2016
                                        5. Yu WJ et al: [Osteonecrosis of the jaw associated with long time withdrawal of bisphosphonates in multiple myeloma: one case report.] Zhonghua Xue Ye Xue Za Zhi. 37(12):1089, 2016
                                        6. Geng CJ et al: Ibandronate to treat skeletal-related events and bone pain in metastatic bone disease or multiple myeloma: a meta-analysis of randomised clinical trials. BMJ Open. 5(6):e007258, 2015
                                        7. Goetze E et al: Osseous plasma cell neoplasm of the mandible for initial diagnosis of multiple myeloma: case report and literature review. J Maxillofac Oral Surg. 14(Suppl 1):469-74, 2015
                                        8. Krstevska S et al: Osteonecrosis of the jaw after bisphosphonates treatment in patients with multiple myeloma. Med Arch. 69(6):367-70, 2015
                                        9. Sun J et al: Bioinformatics analyses of differentially expressed genes associated with bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma. Onco Targets Ther. 8:2681-8, 2015
                                        10. Kamal M et al: Mandibular plasmacytoma of jaw - a case report. J Clin Diagn Res. 8(8):ZD20-1, 2014
                                        11. Mohan RP et al: A multilocular radiolucency of mandible as the first evidence of multiple myeloma: A clinico-radiographic case report. Dent Res J (Isfahan). 11(2):272-5, 2014
                                        12. Patel CG et al: Biomarkers of bone remodeling in multiple myeloma patients to tailor bisphosphonate therapy. Clin Cancer Res. 20(15):3955-61, 2014
                                        13. Tejani N et al: Numb chin syndrome: a case series of a clinical syndrome associated with malignancy. J Med Imaging Radiat Oncol. 58(6):700-5, 2014
                                        14. Troeltzsch M et al: Root resorption caused by jaw infiltration of multiple myeloma: report of a case and literature review. J Endod. 40(8):1260-4, 2014
                                        15. George S et al: Plasma cell myeloma infiltrating the dental pulp: An interesting finding. J Oral Maxillofac Pathol. 17(3):417-9, 2013
                                        16. Rodríguez-Caballero B et al: Mandibular solitary plasmocytoma of the jaw: A case report. Med Oral Patol Oral Cir Bucal. 16(5):e647-50, 2011
                                        17. Elias HG et al: Multiple myeloma presenting as mandibular ill-defined radiolucent lesion with numb chin syndrome: a case report. J Oral Maxillofac Surg. 67(9):1991-6, 2009
                                        18. Neville B et al: Oral and Maxillofacial Pathology. 3rd ed. St. Louis, Missouri: Saunders, 2009
                                        19. Terpos E et al: The use of bisphosphonates in multiple myeloma: recommendations of an expert panel on behalf of the European Myeloma Network. Ann Oncol. 20(8):1303-17, 2009
                                        20. Daneshbod Y et al: Jaw lesion as the first presentation of multiple myeloma diagnosed by fine needle aspiration. Acta Cytol. 52(2):268-70, 2008
                                        21. Vieira-Leite-Segundo A et al: Multiple myeloma with primary manifestation in the mandible: a case report. Med Oral Patol Oral Cir Bucal. 13(4):E232-4, 2008
                                        22. Canger EM et al: Mandibular involvement of solitary plasmocytoma: a case report. Med Oral Patol Oral Cir Bucal. 12(1):E7-9, 2007
                                        23. Baykul T et al: Unusual combination of presenting features in multiple myeloma. Dentomaxillofac Radiol. 33(6):413-9, 2004
                                        24. Mozaffari E et al: Undiagnosed multiple myeloma causing extensive dental bleeding: report of a case and review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 94(4):448-53, 2002
                                        25. Ziegler CM et al: Tender preauricular swelling. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 93(5):516-20, 2002
                                        26. Witt C et al: Radiographic manifestations of multiple myeloma in the mandible: a retrospective study of 77 patients. J Oral Maxillofac Surg. 55(5):450-3; discussion 454-5, 1997
                                        27. Furutani M et al: Mandibular involvement in patients with multiple myeloma. J Oral Maxillofac Surg. 52(1):23-5, 1994
                                        28. Kanazawa H et al: Solitary plasmacytoma of the mandible. Case report and review of the literature. J Craniomaxillofac Surg. 21(5):202-6, 1993
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Multiple myeloma (MM)
                                                  • Synonyms

                                                    • Plasmacytoma
                                                    • Plasma cell myeloma
                                                    • Myeloma
                                                  • Definitions

                                                    • Monoclonal malignant proliferation of plasma cells
                                                      • Solitary plasmacytoma is localized form
                                                    • MM is most common malignancy of bone in adults

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Choi WS et al: Medication-related osteonecrosis of the jaw: a preliminary retrospective study of 130 patients with multiple myeloma. Maxillofac Plast Reconstr Surg. 39(1):1, 2017
                                                                              2. Kitagawa J et al: Efficacy and safety of denosumab in multiple myeloma. Rinsho Ketsueki. 57(5):592-6, 2016
                                                                              3. Kucukkurt S et al: Solitary plasmacytoma of the mandible: report of two cases. BMJ Case Rep. 2016, 2016
                                                                              4. Moura LB et al: Pathologic mandibular fracture as first sign of multiple myeloma. J Craniofac Surg. 27(2):e138-9, 2016
                                                                              5. Yu WJ et al: [Osteonecrosis of the jaw associated with long time withdrawal of bisphosphonates in multiple myeloma: one case report.] Zhonghua Xue Ye Xue Za Zhi. 37(12):1089, 2016
                                                                              6. Geng CJ et al: Ibandronate to treat skeletal-related events and bone pain in metastatic bone disease or multiple myeloma: a meta-analysis of randomised clinical trials. BMJ Open. 5(6):e007258, 2015
                                                                              7. Goetze E et al: Osseous plasma cell neoplasm of the mandible for initial diagnosis of multiple myeloma: case report and literature review. J Maxillofac Oral Surg. 14(Suppl 1):469-74, 2015
                                                                              8. Krstevska S et al: Osteonecrosis of the jaw after bisphosphonates treatment in patients with multiple myeloma. Med Arch. 69(6):367-70, 2015
                                                                              9. Sun J et al: Bioinformatics analyses of differentially expressed genes associated with bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma. Onco Targets Ther. 8:2681-8, 2015
                                                                              10. Kamal M et al: Mandibular plasmacytoma of jaw - a case report. J Clin Diagn Res. 8(8):ZD20-1, 2014
                                                                              11. Mohan RP et al: A multilocular radiolucency of mandible as the first evidence of multiple myeloma: A clinico-radiographic case report. Dent Res J (Isfahan). 11(2):272-5, 2014
                                                                              12. Patel CG et al: Biomarkers of bone remodeling in multiple myeloma patients to tailor bisphosphonate therapy. Clin Cancer Res. 20(15):3955-61, 2014
                                                                              13. Tejani N et al: Numb chin syndrome: a case series of a clinical syndrome associated with malignancy. J Med Imaging Radiat Oncol. 58(6):700-5, 2014
                                                                              14. Troeltzsch M et al: Root resorption caused by jaw infiltration of multiple myeloma: report of a case and literature review. J Endod. 40(8):1260-4, 2014
                                                                              15. George S et al: Plasma cell myeloma infiltrating the dental pulp: An interesting finding. J Oral Maxillofac Pathol. 17(3):417-9, 2013
                                                                              16. Rodríguez-Caballero B et al: Mandibular solitary plasmocytoma of the jaw: A case report. Med Oral Patol Oral Cir Bucal. 16(5):e647-50, 2011
                                                                              17. Elias HG et al: Multiple myeloma presenting as mandibular ill-defined radiolucent lesion with numb chin syndrome: a case report. J Oral Maxillofac Surg. 67(9):1991-6, 2009
                                                                              18. Neville B et al: Oral and Maxillofacial Pathology. 3rd ed. St. Louis, Missouri: Saunders, 2009
                                                                              19. Terpos E et al: The use of bisphosphonates in multiple myeloma: recommendations of an expert panel on behalf of the European Myeloma Network. Ann Oncol. 20(8):1303-17, 2009
                                                                              20. Daneshbod Y et al: Jaw lesion as the first presentation of multiple myeloma diagnosed by fine needle aspiration. Acta Cytol. 52(2):268-70, 2008
                                                                              21. Vieira-Leite-Segundo A et al: Multiple myeloma with primary manifestation in the mandible: a case report. Med Oral Patol Oral Cir Bucal. 13(4):E232-4, 2008
                                                                              22. Canger EM et al: Mandibular involvement of solitary plasmocytoma: a case report. Med Oral Patol Oral Cir Bucal. 12(1):E7-9, 2007
                                                                              23. Baykul T et al: Unusual combination of presenting features in multiple myeloma. Dentomaxillofac Radiol. 33(6):413-9, 2004
                                                                              24. Mozaffari E et al: Undiagnosed multiple myeloma causing extensive dental bleeding: report of a case and review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 94(4):448-53, 2002
                                                                              25. Ziegler CM et al: Tender preauricular swelling. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 93(5):516-20, 2002
                                                                              26. Witt C et al: Radiographic manifestations of multiple myeloma in the mandible: a retrospective study of 77 patients. J Oral Maxillofac Surg. 55(5):450-3; discussion 454-5, 1997
                                                                              27. Furutani M et al: Mandibular involvement in patients with multiple myeloma. J Oral Maxillofac Surg. 52(1):23-5, 1994
                                                                              28. Kanazawa H et al: Solitary plasmacytoma of the mandible. Case report and review of the literature. J Craniomaxillofac Surg. 21(5):202-6, 1993