MANDİBULADA MULTİPL MYELOMA İKİ OLGU SUNUMU

Abstract

Multipl myeloma MM , erişkin çağın en sıkgörülen kemik tümörlerindendir. MM genellikle,kafatası, klavikula, vertebra, pelvis gibi yassıkemikleri tutar. Bu makalede mandibula posterior bölgeyitutan iki MM olgusu sunulmaktadır. İlk olgumuz57 yaşında alt çene sol tarafta ağrılı yumuşak dokukitlesi ile başvuran erkek hasta idi. İkinci olgumuzise 46 yaşında herhangi bir klinik şikayeti olmaks›z›n başvuran erkek hastayd›. Histopatolojik değerlendirmelerinde, plazma hücre infiltrasyonu ve immunohistokimyasal olarak kappa hafif zincir monoklonalitesi gözlenmiştir. MM 'da oral bulgular›n ortaya ç›kmas›, hastan›n ileri dönemde olduğuna işaret eder. Bu nedenle multipl myelomada olgular›n›n dikkatli değerlendirilmesi ve multidisipliner yaklaş›m gereklidir

Keywords

• multipl myeloma, plazmahücreli tümör

Multiple Myeloma of the Mandible Report of two cases

Abstract

Multiple myeloma MM is the most commonencountered malignant neoplasm of bone in adults.MM is generally seen in flat bones of skeleton suchas the skull, clavicle, vertebrae, and pelvis. In this article two cases of MM involved in themandible are presented. Our first case was a 57year- old man with a painful soft tissue mass atthe left side of his mandible. The second case was a46 year- old man without any clinical symptoms.The histopathologic evaluation revealed a plasmacell infiltration showing kappa light chainmonoclonality in the immunohistochemicalexamination. In both cases, the presence of oralfindings in the MM, suggest a terminal stage ofthe disease. Therefore, great attention must bepaid to the examination of such individuals andmultidisciplinary approach to the disease must beaccomplished

Keywords

• multiple myeloma, plasma cellneoplasm

References

1. Lae ME, Vencio EF, Inwards CY, Unni KK, Nascimento AG. Myeloma of the jaw bones: a clini- copathologic study of 33 cases. Head Neck 2003; 25: 373-81.
2. Cawson RA, Binnie WH, Eveson JW. Color atlas of oral disease clinical and pathologic correlations. 2nd ed. London: Mosby Co;1994; 712- 3.
3. Miles DA, Kaugars GE, van Dis M, Lovas LGL. Oral and maxillofacial radiology radiologic/ pathologic correlations. Philadelphia: WB Saunders Co;1991:101-13.
4. Hogan MC, Lee A, Solberg LA, Thome SD. Unusual presentation of multiple myeloma with visual loss and numb chin sendrome in a young adult. Am J Hematol 2002; 70: 55-9.
5. Pisano JJ, Coupland R, Chen SY, Miller AS. Plasmositoma of oral cavity and jaws. Oral Surg Oral Med Oral Pathol 1997; 83: 265-71.
6. Regezi JA, Sciuba J,Jordan JRK.Oral Pathology Clinical- Pathologic Correlations. 4th.ed.USA: Elsevier Sience; 2003; 411-3.
7. DeRossi SS, Garfunkel A, Greenberg MS. Hematologic Diseases. In:Greenberg MS, Glik M. Burket’s oral medicine diagnosis treatment. 10th ed. Spain:BC Decker, 2003; 451-3.
8. Lambertenghi G, Burno E, Cortelezzi A, Fumagalli L, Morosani A: Incidence of jaw lesions in 1993 patient with multiple myeloma. Oral Surg Oral Med Oral Pathol 1988; 65:533-7.

9. Petit JC, Ripamonti U. Multiple myeloma of the periodontium. A case report. J Periodontol 1990; 61: 132-7.
10. Raunbenheimer EJ, Daut M. Multiple myeloma presenting with oral and perioral amyloidosis. Oral Surg Oral Med Oral Pathol 1986; 61:492-7.
11. Gorlin RJ, Goldman HM. Thoma’s Oral pathology.6th ed. Vol. 2 St Louis: Mosby Co,1970; 951-3.
12. Wood NK, Goaz PW. Differential diagnosis of oral lesions. 4 th ed. St. Louis: Mosby Co,1991;464-6.
13. Witt C, Borges AC, Klein K, Neumann HJ. Radiographic manifestations of multiple myeloma in the mandibe: a retrospective study of 77 patients. J Oral Maxillofacial Surg 1997; 55: 450-3.
14. Lee SH, Huang JJ. Pan WL, Chan CP.Gingival mass as the primary manifestation of multiple myeloma. Oral Surg Oral Med Oral Pathol 1996; 82:75-9.
15. Scopp IW. Oral medicine a clinical aproach with basic sience correlation. 2 nd ed. St Louis: Mosby Co; 1973:303-5.
16. Krauth RA Buhler JE, LaRue JR, Acevedo A. Amyloidosis associated with multiple myeloma Oral Surg1977; 43: 63-8.
17. Flick WG, Lawrence RL. Oral amyloidosis as an initial symptom of multiple myeloma. A case report. Oral Surg 1980; 49:18-20.
18. Blomgren J, Back H. Oral hairy leukoplakia in a patient with multiple myeloma . Oral Surg Oral Med Oral Pathol 1996; 82: 408-10.
19. Ozaki M, Yamanaka H. An usual case of Bence Jones myeloma with extremly low levels of monoclonal immunoglobulin. Oral Surg Oral Med Oral Pathol 1986; 61:498-503.
20. Zeigler CM, Flechtenmacher C, Muhling C. Tender preauricular swelling. Oral Surg Oral Med Oral Pathol 2002;93:516-20.
21. Catley L, Anderson K. Strategies to improve the outcome of stem cell transplantation in multiple myeloma. Hematol J 2004;5:9-23.
22. Bishay N, Petrikowski CG, Maxymiw WG, Lee L, Wood RE. Optimum dental radiography in bone marrow transplant patients. Oral Surg Oral Med Oral Pathol 1999; 87:375-9.
23. Sager RD, Theis RM. Dental implants placed in a patient with multiple myeloma: report of case. J Am Dent Assoc1990; 121:699-701.