Mandibular mass as the presenting manifestation of IgM myeloma in a 22-year-old man

Abstract

We report here the youngest known IgM myeloma patient to have presented with a mandibular mass. A 22-year-old Chinese man sought medical attention due to a mass over his right mandible that had been growing progressively for 6 months. A solitary osteolytic lesion in the right mandible was identified radiologically. Incisional biopsy revealed the presence of plasma cells of monoclonal origin, as evidenced by the exclusively positive staining of the kappa light chain. The diagnosis of multiple myeloma with mandibular involvement was confirmed by bone marrow examination. Further tests, including immunoglobulin electrophoresis and assay of the serum levels of kappa and lambda light chains, demonstrated that his myeloma was of the IgM, kappa subtype. The patient achieved a nonsustained partial response to six courses of melphalan and prednisolone therapy and palliative radiotherapy.

IgM multiple myeloma presenting with spinal cord compression caused by a plasmacytoma: A case report

“…However, soft tissue is the commonest site involved. Having higher serum C-reactive protein and lactic dehydrogenase levels and the presence of a more advanced stage for international staging system (ISS), anemia and extramedullary tumors are the main poor prognostic factors of MM [ 3 , 4 ]. Waldenstrom's macroglobulinaemia (WM) is a B-cell lymphoproliferative disorder characterized primarily by the infiltration of lymphoplasmacytic cells into the bone marrow and the demonstration of IgM monoclonal gammopathy [ 5 - 8 ].…”

Osseous Plasma Cell Neoplasm of the Mandible for Initial Diagnosis of Multiple Myeloma: Case Report and Literature Review

“…Together with the current report, a total of 11 articles describing 13 patients with mandibular plasmocytoma as initial diagnosis of MM were included [4][5][6][7][8][9][10][11][12][13] (Table 1). The mean age was 59.9 years (min: 22, max: 81); female patients (54 %) were affected slightly more often than males (46 %).…”

Bone Marrow Mastocytosis Associated with IgM Kappa Plasma Cell Myeloma

“…The histological diagnosis of plasmacytoma was based on the presence of an elevated level of monoclonal serum IgM (paraproteinemia) and a marked increase in cytomorphologically atypical plasma cells which made up about 20 to 30% of all nucleated bone marrow cells exhibiting monotypic staining for immunoglobulin light chain kappa and heavy chain mu. IgM plasmacytoma/myeloma is an extremely rare subtype amongst plasma cell dyscrasias with only a few published case reports [8,9]. Since IgM paraproteinemia is usually associated with small cell lymphocytic neoplasms of immunocytoma subtype, a malignant lymphoma had to be considered first in the differential diagnosis [10].…”