title: Mandibular destructive radiolucent lesion: The first sign of multiple myeloma.
abstract: The occurrence of a mandibular lesion as the first sign of multiple myeloma (MM) is uncommon. This report describes a case of MM diagnosed because of a mandibular lesion. A 62-year-old woman presented a destructive radiolucent lesion in the right mandibular ramus. The lesion caused rupture of the anterior cortical bone and extended from the retromolar area to the coronoid process. An incisional biopsy was performed. Histopathological examination revealed numerous pleomorphic plasma cells, some with binucleated nuclei. The tumor cells showed kappa light-chain restriction. Bone marrow biopsy showed findings of massive infiltration of neoplastic plasma cells, besides lesions in the vertebrae. The diagnosis of MM was established. The patient underwent autologous hematopoietic stem-cell transplantation. Currently, the patient is under regular follow up after 40 months of initial treatment. In conclusion, MM should be considered in the differential diagnosis of destructive mandibular lesions.Key words:Mandible, multiple myeloma, radiolucent lesion.
authors.affiliation: Department of Oral Medicine, Hospital Sírio-Libanês, São Paulo, Brazil.
authors.forename: Eduardo-Rodrigues
authors.initials: ER
authors.lastname: Fregnani
authors.affiliation: Department of Clinical and Preventive Dentistry, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Amanda-Almeida
authors.initials: AA
authors.lastname: Leite
authors.affiliation: Department of Oral Medicine, Hospital Sírio-Libanês, São Paulo, Brazil.
authors.forename: Claudia-Joffily
authors.initials: CJ
authors.lastname: Parahyba
authors.affiliation: Department of Oral Medicine, Hospital Sírio-Libanês, São Paulo, Brazil.
authors.forename: Ana-Cristina-Alo
authors.initials: AC
authors.lastname: Nesrallah
authors.affiliation: Department of Clinical and Preventive Dentistry, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Flávia-Maria-de Moraes
authors.initials: FM
authors.lastname: Ramos-Perez
authors.affiliation: Department of Clinical and Preventive Dentistry, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Danyel-Elias-da Cruz
authors.initials: DC
authors.lastname: Perez