Publication:
Oral Manifestations of Malignant Immunoglobinopathy Hidden in Plain Sight - A Rare Case Report

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Date

2023

Journal Title

Annals of Maxillofacial Surgery

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Wolters Kluwer Medknow Publications

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Abstract

Rationale: Radiolucent lesions over the angle-body region of the mandible are frequently difficult to diagnose but crucial to provide patient-centred care. Patient Concerns: An elderly female presented with a painless slow-growing swelling over her left lower face for one year, radiographically appearing as a well-defined unilocular radiolucency over the left body of the mandible. Diagnosis: Aspiration was negative, and biopsy was inconclusive. Further imaging, bone marrow biopsy, immune profile and serum electrophoresis confirmed the diagnosis of multiple myeloma. Treatment: She was referred to Medical Oncology for chemotherapy of lenalidomide, bortezomib and dexamethasone regimen cycle that was repeated every 21 days. Outcomes: There was no increase in swelling, and radiographically 'punched-out' lesions were reduced significantly. Take-Away Lessons: Maxillofacial clinicians should be attentive to the oral manifestations of underlying disease, have a high index of suspicion and start the treatment promptly to increase chances of a favourable outcome. � 2023 Annals of Maxillofacial Surgery.

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Keywords

Mandible, multiple myeloma, radiolucent lesion

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