title: Osseous plasma cell neoplasm of the mandible for initial diagnosis of multiple myeloma: case report and literature review.
abstract: OBJECTIVE
  Plasmocytoma of the bone represents a variance of plasma cell neoplasms, which often gives hint for systemic affection. A case of a mandibular tumor as first manifestation of multiple myeloma (MM) is presented and discussed with the literature.
  
  
  METHODS
  A 76-year old female with pain and swelling of the right lower jaw was assigned to the hospital. Radiograph showed a lytic tumor at the mandibular condyle and histological analysis gave evidence of a plasma cell tumor with positivity to CD138. In further examinations, elevated immunoglobulin levels in serum and osseous plasma cell infiltration unveiled MM. PubMed-database was searched by "multiple myeloma primary lesion jaw", "multiple myeloma primary manifestation mandible" and "multiple myeloma mandibular lesion" within the last 30 years.
  
  
  RESULTS
  Together with the current case, 11 reports including 13 patients were found describing mandibular plasmocytoma as first sign for MM. Mean age was 59 years with slight female preference. Initial symptoms were mostly swelling episodes with or without pain. The main radiological presentation was a uni- or multilocular radiolucency. After a mean follow up time of 29 months (stated in 8 cases; standard deviation 50, min: 1, max: 151), 3/8 patients died and in 5/8 cases, signs of progress were seen.
  
  
  CONCLUSIONS
  In rare cases, occurrence of plasmocytoma of the mandible is first sign for MM and should always lead to further investigations regarding systemic disease. Simple examinations such as panoramic X-rays can lead to early detection of MM and thereby better prognosis by earlier treatment.
authors: Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany.
authors: E
authors: E
authors: Goetze
authors: Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany.
authors: C
authors: C
authors: Walter
authors: M.R. Ambedkar Dental College and Hospital, Bangalore, India ; Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Schillingallee 35, 18055 Rostock, Germany.
authors: P W
authors: PW
authors: Kämmerer
keywords: Literature review; Lower jaw; Mandible; Multiple myeloma; Plasma cell tumor; Plasmocytoma