title: [An unusual toothache!].
abstract: BACKGROUND
  Dental pain is a frequent reason for consulting. It may have non-odontogenic causes such as lesions of vascular, neurologic, muscular, or bone structures. The diagnosis and management of this acute or chronic pain syndrome may be difficult. We report a case of atypical dental pain leading to the diagnosis of a plasmocytic mandibular tumor revealing a multiple myeloma.
  
  
  METHODS
  A 50-year-old female patient consulted for dental pain during the 3 previous months. Bilateral mandibular swelling was noted during the clinical examination. Radiological examinations revealed a tumoral process associated with osteolytic lesions. The pathological examinations of biopsy samples revealed plasmocytic proliferation. A myelogram and immunoglobulin electrophoresis supported a diagnosis of multiple myeloma with kappa light chains.
  
  
  CONCLUSIONS
  Discovering a mandibular tumor with lytic lesions is an indication for an etiological assessment and screening for a blood disease. A mandibular plasmacytoma may be isolated or present as a multiple myeloma, justifying a complete initial assessment. The bone localization of a plasmacytoma is a bad prognostic factor for survival for patients presenting with multiple myeloma.
authors.affiliation: Service de médecine interne B, hôpital Charles-Nicolle, faculté de médecine de Tunis, université de Tunis El Manar, boulevard du 9-Avril-1938, Tunis, Tunisia. eyacherif@yahoo.fr
authors.forename: E
authors.initials: E
authors.lastname: Cherif
authors.forename: L
authors.initials: L
authors.lastname: Ben Hassine
authors.forename: S
authors.initials: S
authors.lastname: Azzabi
authors.forename: Z
authors.initials: Z
authors.lastname: Kaoueche
authors.forename: I
authors.initials: I
authors.lastname: Boukhris
authors.forename: N
authors.initials: N
authors.lastname: Khalfallah
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008339:Mandibular Neoplasms / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis*; D010954:Plasmacytoma / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014098:Toothache / Q000175:diagnosis* / Q000209:etiology