Multiple myeloma and chemical maxillary osteonecrosis. Can both occur simultaneously?

Junquera, S.; Álvarez-Yagüe, E.; Junquera, Luís; Ugalde, Ricardo López; Rúa, Laura Melissa

doi:10.1016/j.jormas.2019.12.002

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…Clinical features of OM have also been documented to be difficult to discern. OM has been reported as extraoral swelling, 5 non‐healing extraction socket, 20 cortical expansion, 19 exophytic gingival mass, 21 paresthesia 22 and/or fistula through which bone can be probed 22 . Unlike MRONJ, OM does not require exposed bone for diagnosis 5 …”

Section: Discussionmentioning

confidence: 99%

“…22 Unlike MRONJ, OM does not require exposed bone for diagnosis. 5 When there is high suspicion for OM, histological analysis from gingival and/or bony biopsy is warranted. Clinicians however must weigh the benefits of the biopsy with the risk for development of MRONJ.…”

Section: Discussionmentioning

confidence: 99%

“…Zoledronic acid has been shown to reduce SRE with possible anti‐tumour effect, improving the overall survival rate of patients with MM 3 . Oral manifestations associated with multiple myeloma (OM) are rare and often signifies a poor prognosis as it is typically indicative of a widespread disease 4,5 . The incidence of radiographic OM in the mandible has been reported as 5.18% 6 .…”

Section: Introductionmentioning

confidence: 99%

“…3 Oral manifestations associated with multiple myeloma (OM) are rare and often signifies a poor prognosis as it is typically indicative of a widespread disease. 4,5 The incidence of radiographic OM in the mandible has been reported as 5.18%. 6 Once OM is diagnosed, palliative treatment with localized radiation therapy, systemic chemotherapy, or a combination of these can significantly improve and maintain patient's quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Multiple myeloma masquerading as mandibular medication‐related osteonecrosis of the jaw: a case report

Danskin

Alhajji

Singh

et al. 2021

Australian Dental Journal

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This is a unique case report of a 67‐year‐old female diagnosed with multiple myeloma and extensive use of intravenous bisphosphonate, whose clinical and radiographic presentation of an oral lesion made it challenging to confirm its definitive diagnosis. This patient was referred to the dental service for a suspected medication‐related osteonecrosis of the jaw (MRONJ). Clinically, the lesion was located underneath a fixed partial denture in the left posterior mandible. There was a purulent swelling on the lingual side of the fixed partial denture, and a hyperplastic exophytic lesion on the buccal side of the bridge. Panoramic radiograph showed a well circumscribed radiolucent lesion in the left mandible. A biopsy of the gingival lesion on the buccal aspect was inconclusive. As the positron emission tomography scan showed lytic lesions, oral manifestation of multiple myeloma could not be ruled out. A computed tomography‐guided biopsy of the left mandible showed plasma cell neoplasm in the histological analysis. Upon confirmed diagnosis, the patient was treated with 20Gy to the left mandible and subsequent debridement of the loose necrotic bone. Following treatment, this gingival lesion resolved completely, and the tumour has remained stable till date.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multiple myeloma masquerading as mandibular medication‐related osteonecrosis of the jaw: a case report

Danskin

Alhajji

Singh

et al. 2021

Australian Dental Journal

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“…The 2 diseases have similar clinical manifestations and imaging findings. There are several reports about MM disguised as MRONJ, [7][8][9][10][11] in which the cases were initially diagnosed as MRONJ clinically but were later confirmed to be MM through pathological analysis, while simultaneous finding of MRONJ and MM in same site has been rarely reported. In this report, the patient was previously clinically and pathologically diagnosed as MRONJ, but 1 year later, MM was found pathologically in the surgical specimen that involved with MRONJ.…”

Section: Introductionmentioning

confidence: 99%

Multiple myeloma identified within the same site of the mandible with medication-related osteonecrosis of jaw: An unusual case report

Chen

2023

Medicine

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Rationale: Multiple myeloma (MM) is a malignant disease characterized by abnormal proliferation of plasma cells, which usually occurs in middle-aged and elderly male patients. Bisphosphonates (BP) are commonly used for the treatment of MM bone disease. Long-time use of BP may cause medication-related osteonecrosis of the jaw (MRONJ). MRONJ occurs in jaw exclusively, and Multiple myeloma can also invade the jaw. The 2 diseases have similar clinical manifestations and imaging findings. This report present a case of MM identified in surgical specimen at the site that had been previously pathologically diagnosed as MRONJ in a patient with MM. Patient concerns: A 57-years-old male patient visited our clinic on October 16, 2020 because of gingival swelling and pain in the right mandible for 1 month after extraction of the lower right premolar. The patient had a long-time illness history of multiple myeloma, and received intravenous zoledronic acid treatment. Diagnoses: Based on the clinical characteristics, imaging, and pathological findings of sequestrum formation and high inflammatory cell infiltration, the patient was diagnosed with MRONJ. After 1 year, a mandibular osteotomy was performed and pathological analysis showed the presence of necrotic bone and a large number of abnormal plasma cell infiltration, suggesting the presence of MM in the mandible. Interventions: The patient was treated with a series of conservative treatments including antibiotic treatment, saline irrigation and laser irradiation, as well as superficial sequestration was. One year later, a mandibular osteotomy was performed. Outcomes: For the patient, the symptoms of gingival swelling, pain and discharge disappeared after surgery. Lessons: These findings suggested MRONJ and MM could occur simultaneously at same site, so patients with MM presenting with symptoms of MRONJ should be screened for concurrent or disease relapse of multiple myeloma to prevent misdiagnosis or inadequate management. Meanwhile, this also suggests long-term inflammatory may lead to invasion of multiple myeloma.

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Medication-related osteonecrosis of the jaw in a patient with multiple myeloma: an unusual case with tumor in the surgical specimen

et al. 2021

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Multiple myeloma and chemical maxillary osteonecrosis. Can both occur simultaneously?

Cited by 6 publications

References 14 publications

Multiple myeloma masquerading as mandibular medication‐related osteonecrosis of the jaw: a case report

Multiple myeloma masquerading as mandibular medication‐related osteonecrosis of the jaw: a case report

Multiple myeloma identified within the same site of the mandible with medication-related osteonecrosis of jaw: An unusual case report

Medication-related osteonecrosis of the jaw in a patient with multiple myeloma: an unusual case with tumor in the surgical specimen

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