Radiographic manifestations of multiple myeloma in the mandible

Mandibular involvement in patients with multiple myeloma

A survey of changes in the jaw bones of 38 patients with multiple myeloma revealed five cases with mandibular involvement. One case showed a pathological fracture of the mandibular angle, and in another case, a radiolucent area was found in the body of the mandible. These two clinical findings led to the diagnosis of multiple myeloma. The other three cases had no symptoms related to the oral region. All five cases also showed typical "punched-out" lesions in the skull. It is suggested that a skeletal radiologic survey including the jaw should be performed in patients with multiple myeloma.

Plasma cell dyscrasias: current status

This is a review of the current status of the monoclonal gammopathies (plasma cell dyscrasias). We begin with the recognition of a monoclonal protein in serum and urine. We briefly discuss the differential diagnosis of the monoclonal gammopathies. Clinical and laboratory findings as well as the management of multiple myeloma are addressed. Future approaches for the treatment of myeloma are provided. The variant forms of multiple myeloma, including smoldering myeloma, plasma cell leukemia, nonsecretory myeloma, IgD myeloma, osteosclerotic myeloma, solitary plasmacytoma of bone, and extramedullary plasmacytoma, are briefly reviewed. Diagnosis and treatment of Waldenström's macroglobulinemia are presented. The recognition and differential diagnosis of the heavy-chain diseases (gamma, alpha, and mu) are included. Monoclonal gammopathy of undetermined significance ("benign" monoclonal gammopathy) is presented in detail. Amyloidosis is not included in this review.