Tooth Extraction Locally Stimulates Proliferation of Multiple Myeloma in a Patient with Mandibular Localizations

Objectives: Multiple myeloma (MM) is characterized by the occurrence of osteolytic lesions. MM treatment usually involves antiresorptive drugs (mainly bisphosphonates). Case Report: A patient with an MM presented osteolytic lesions of the mandible. Extraction of teeth 45 and 46 was performed 5 years after the diagnosis of periodontitis. Four months later, osteonecrosis of the jaw (ONJ) was diagnosed at the extraction site. X-ray showed an extension of osteolytic lesions on the right side, close to the extraction site, without modification of the lesions on the left side. Two months later, a curettage was performed because of a painful bone sequestration. X-ray showed an extension of the osteolytic lesions on the right side. Results: Histological analysis found a vascularized plasmacytoma of the soft tissues around the ONJ. Analysis of the bone showed mixed lesions with osteonecrotic areas and living bone resorbed by active osteoclasts surrounding a plasmacytoma. The surface area of the osteolytic foci has considerably increased only close to the extraction site. Conclusions: Tooth extraction triggered an ONJ associated with bisphosphonate treatment. However, it also seemed to induce a considerable proliferation of plasma cells at the extraction site; we hypothesize that it is due to the increase in bone remodeling related to the surgical trauma.

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Extramedullar plasmocytoma of the oral cavity

Journal of Oral Medicine and Oral Surgery ◽

10.1051/mbcb/2020025 ◽

2020 ◽

Vol 26 (4) ◽

pp. 40

Author(s):

Helen Olugbeje ◽

Arthur Fourcade

Keyword(s):

Multiple Myeloma ◽

Differential Diagnosis ◽

Oral Cavity ◽

Histological Examination ◽

Plasma Cell ◽

Soft Tissues ◽

Cell Disease ◽

X Ray ◽

The Right

Introduction: Extramedullar plasmocytoma (EMP) is a plasma cell disease, such as solitary plasmocytoma of the bone and multiple myeloma. It is developed in the soft tissues. Observation: A 79-year-old patient consulted for a painful tumefaction of the gum associated to a radiolucent area on the right side of the mandible on the panoramic x-ray. After surgical enucleation, histological examination showed that the diagnosis was either an IgA extramedullar plasmocytoma or a multiple myeloma. The spreading assessment eliminated the diagnosis of multiple myeloma. The patient was then treated with radiotherapy. Discussion: EMP is a rare tumoral disease. Few cases described oral localisation. The main differential diagnosis, that must be excluded is multiple myeloma. Transformation in multiple myeloma exists. The first intention treatment is radiotherapy of the lesion. Conclusion: EMP of the oral cavity is very rare. After treatment, follow-up is required to detect second localisation or progression in multiple myeloma.

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The massive nodular cutaneous and soft tissues lesions of the right shoulder and the arm as the extramedullary manifestation of the advanced stage of multiple myeloma

Oncoreview ◽

10.24292/01.or.201217 ◽

2017 ◽

Vol 7 (4) ◽

pp. 180-183

Author(s):

Arkadiusz Drobiecki ◽

Marcin Pasiarski ◽

Agnieszka Stelmach-Gołdyś ◽

Bartosz Garus

Keyword(s):

Multiple Myeloma ◽

Soft Tissues ◽

Advanced Stage ◽

The Right

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A hematologic condition expressed as a lung disease

F1000Research ◽

10.12688/f1000research.1-28.v1 ◽

2012 ◽

Vol 1 ◽

pp. 28 ◽

Cited By ~ 1

Author(s):

Mónica Egozcue-Dionisi ◽

José Nieves-Nieves ◽

Ricardo Fernández-Gonzalez ◽

Rosángela Fernández-Medero ◽

Raúl Reyes-Sosa ◽

...

Keyword(s):

Multiple Myeloma ◽

Pleural Effusion ◽

Plasma Cells ◽

Rare Complication ◽

Disease Stage ◽

Fluid Analysis ◽

Progressive Dyspnea ◽

Breath Sounds ◽

The Right ◽

Pleural Involvement

Pleural involvement secondary to Multiple Myeloma is considered a very rare complication. According to the literature only 1% of these patients develop a myelomatous pleural effusion. We present a case of a 39 year old man with multiple myeloma diagnosed six years prior to our evaluation, which developed progressive dyspnea, dry cough and right pleuritic chest pain two weeks prior to admission. On physical examination the patient had decreased breath sounds over the right posterior hemithorax accompanied by dullness to percussion. The chest radiogram was consistent with a right sided pleural effusion. Pleural fluid analysis revealed the presence of abundant abnormal plasma cells. The patient died four weeks after hospitalization. The presence of myelomatous pleural effusion is considered to be a poor prognostic finding, no matter at what disease stage it develops. So far no definite treatment has been shown to improve survival.

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A Rare Case of Extramedullary Relapse of Multiple Myeloma Causing Bowel Obstruction

Case Reports in Hematology ◽

10.1155/2019/4962678 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Prarthna V. Bhardwaj ◽

Shrinkhala Khanna ◽

Majd D. Jawad ◽

Syed S. Ali

Keyword(s):

Multiple Myeloma ◽

Bowel Obstruction ◽

Rare Case ◽

Soft Tissues ◽

Plasma Cells ◽

Case Reports ◽

Rare Entity ◽

Risk Gene ◽

Gene Profiles ◽

Extramedullary Relapse

Extramedullary myeloma, defined by presence of plasma cells outside the bone marrow, is a rare entity accounting for about 3–9% of all cases. It usually is aggressive with a median survival of <6 months. It is also associated with adverse prognostic factors including 17p deletions and high-risk gene profiles. While common extramedullary sites include bones, there have been several case reports of hematogenous extramedullary myeloma to the liver, lungs, pancreas, breast, skin, and soft tissues. Extramedullary myeloma to the mesentery is a rare entity with only a handful of cases reported. We present a case of 69-year-old man presenting with relapse of multiple myeloma to the mesentery, resulting in bowel obstruction to highlight the various presentations of myeloma.

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Functional Comparison between Healthy and Multiple Myeloma Adipose Stromal Cells

Stem Cells International ◽

10.1155/2020/4173578 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Nicolas Espagnolle ◽

Benjamin Hebraud ◽

Jean-Gérard Descamps ◽

Mélanie Gadelorge ◽

Marie-Véronique Joubert ◽

...

Keyword(s):

Multiple Myeloma ◽

Stromal Cells ◽

Cellular Therapy ◽

Plasma Cells ◽

Bone Lesions ◽

Adipose Stromal Cells ◽

Osteolytic Lesions ◽

Healthy Donors ◽

Bone Damage ◽

First Time

Multiple myeloma (MM) is an incurable B cell neoplasia characterized by the accumulation of tumor plasma cells within the bone marrow (BM). As a consequence, bone osteolytic lesions develop in 80% of patients and remain even after complete disease remission. We and others had demonstrated that BM-derived mesenchymal stromal cells (MSCs) are abnormal in MM and thus cannot be used for autologous treatment to repair bone damage. Adipose stromal cells (ASCs) represent an interesting alternative to MSCs for cellular therapy. Thus, in this study, we wondered whether they could be a good candidate in repairing MM bone lesions. For the first time, we present a transcriptomic, phenotypic, and functional comparison of ASCs from MM patients and healthy donors (HDs) relying on their autologous MSC counterparts. In contrast to MM MSCs, MM ASCs did not exhibit major abnormalities. However, the changes observed in MM ASCs and the supportive property of ASCs on MM cells question their putative and safety uses at an autologous or allogenic level.

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Altered Long Noncoding RNA Expression Profile in Multiple Myeloma Patients with Bisphosphonate-Induced Osteonecrosis of the Jaw

BioMed Research International ◽

10.1155/2020/9879876 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Alessandro Allegra ◽

Manuela Mania ◽

Angela D’Ascola ◽

Giacomo Oteri ◽

Enrico Nastro Siniscalchi ◽

...

Keyword(s):

Multiple Myeloma ◽

Metabolic Pathways ◽

Noncoding Rna ◽

Protective Action ◽

Noncoding Rnas ◽

Osteonecrosis Of The Jaw ◽

Base Pairs ◽

Osteolytic Lesions ◽

Ctrl Group ◽

Rna Molecules

Bisphosphonates (BPs) are inhibitors of osteoclast-mediated bone resorption used for the treatment of multiple myeloma (MM) patients with osteolytic lesions. Bisphosphonate-induced osteonecrosis of the jaw (BONJ) is an infrequent drug-caused adverse event of these agents. Long noncoding RNAs (lncRNAs) are a set of more than 200 base pairs, noncoding RNA molecules, which are critical posttranscriptional regulators of gene expression. Our study was aimed at evaluating 17 lncRNAs, whose targets were previously validated as key elements in MM, bone metabolism, and angiogenesis in MM subjects without BONJ (MM group), in MM subjects with BONJ (BONJ group), and a group of healthy controls (CTRL group). Our results demonstrated a different lncRNA profile in BONJ patients compared to MM patients and controls. Two lncRNAs (DANCR and MALAT1) were both downregulated compared to controls and MM, twelve (HOTAIR, MEG3, TP73-AS1, HOTTIP, HIF1A-AS2, MANTIS, CTD-2201E18, CTD1-2003C8, R-471B22, RP1-43E13, RP11-553L6.5, and RP1-286D6) were overexpressed in MM with BONJ, and one (H19) was upregulated compared with only MM. Two lncRNAs (JHDMD1 and MTMR9LP) had higher expression, but these differences were not statistically significant. The examined lncRNAs target several genes and metabolic pathways. An altered lncRNA signature could contribute to the onset of BONJ or have a protective action. Targeting these lncRNAs could offer a possibility for the prevention or therapy of BONJ.

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Calcium Phosphate Ceramics Can Prevent Bisphosphonate-Related Osteonecrosis of the Jaw

Materials ◽

10.3390/ma13081955 ◽

2020 ◽

Vol 13 (8) ◽

pp. 1955

Author(s):

Siri Paulo ◽

Mafalda Laranjo ◽

Anabela Paula ◽

Ana Margarida Abrantes ◽

João Martins ◽

...

Keyword(s):

Nuclear Medicine ◽

Calcium Phosphate ◽

Tooth Extraction ◽

Soft Tissues ◽

Calcium Phosphates ◽

Test Group ◽

Osteonecrosis Of The Jaw ◽

In Vivo Model ◽

Calcium Phosphate Ceramics

Bisphosphonate-associated osteonecrosis of the jaw (BRONJ), a post-surgical non-healing wound condition, is one of the most common side effects in patients treated with nitrogen-containing bisphosphonates. Its physiopathology has been related with suppression of bone turnover, of soft tissue healing and infection. Biphasic calcium phosphates (BCP) are used as a drug delivery vehicle and as a bone substitute in surgical wounds. Due to their capacity to adsorb zoledronate, it was hypothesized these compounds might have a protective effect on the soft tissues in BRONJ wounds. To address this hypothesis, a reproducible in vivo model of BRONJ in Wistar rats was used. This model directly relates chronic bisphosphonate administration with the development of osteonecrosis of the jaw after tooth extraction. BCP granules were placed in the alveolus immediately after tooth extraction in the test group. The animals were evaluated through nuclear medicine, radiology, macroscopic observation, and histologic analysis. Encouragingly, calcium phosphate ceramics were able to limit zoledronate toxicity in vivo and to favor healing, which was evidenced by medical imaging (nuclear medicine and radiology), macroscopically, and through histology. The studied therapeutic option presented itself as a potential solution to prevent the development of maxillary osteonecrosis.

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Maxillary Swelling as the First Evidence of Multiple Myeloma

Case Reports in Dentistry ◽

10.1155/2015/439536 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Atsushi Kasamatsu ◽

Yasushi Kimura ◽

Hideki Tsujimura ◽

Harusachi Kanazawa ◽

Nao Koide ◽

...

Keyword(s):

Multiple Myeloma ◽

Plasma Cells ◽

Malignant Neoplasm ◽

Magnetic Resonance Images ◽

Oral Manifestations ◽

Tissue Mass ◽

Old Japanese ◽

Single Clone ◽

Buccal Space ◽

The Right

Multiple myeloma is a malignant neoplasm of plasma cells characterized by proliferation of a single clone of abnormal immunoglobulin-secreting plasma cells. Since the amount of hemopoietic bone marrow is decreased in the maxilla, oral manifestations of multiple myeloma are less common in the maxilla than in the mandible. We report the case of 33-year-old Japanese man who presented with a mass in the right maxillary alveolar region. Computed tomography and magnetic resonance images showed a soft tissue mass in the right maxilla eroding the anterior and lateral walls of the maxillary sinus and extending into the buccal space. The biopsy results, imaging, and laboratory investigations led to the diagnosis of multiple myeloma. This case report suggests that oral surgeons and dentists should properly address oral manifestations as first indications of multiple myeloma.

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A Case of Surgical Extraction of the Lower Third Molars in a Cranial Series from the Pucará de Tilcara Fortress (Jujuy Province, Argentina)

Archaeology Ethnology and Anthropology of Eurasia ◽

10.17746/1563-0110.2020.48.2.149-156 ◽

2020 ◽

Vol 48 (2) ◽

pp. 149-156

Author(s):

A. V. Zubova ◽

O. L. Pikhur ◽

A. V. Obodovskiy ◽

A. A. Malyutina ◽

L. M. Dmitrenko ◽

...

Keyword(s):

Soft Tissues ◽

Third Molar ◽

Pathological Process ◽

Stone Tool ◽

Third Molars ◽

Dental Surgery ◽

X Ray ◽

Surgical Extraction ◽

Ct Analysis ◽

The Right

This study analyzes the earliest known case of surgical extraction of the lower third molars, observed in a cranial series from Pucará de Tilcara fortress (15th–16th centuries AD), northwestern Argentina, excavated in 1908–1910. Crania were transported to the Kunstkamera in 1910 under an exchange project. Traces of dental surgery were registered in the mandible of a male aged ~40. Both third molars had been extracted after the removal of soft tissues and parts of the alveoli. Teeth were extracted by scraping alveolar walls with semicircular movements. The results of scanning electron microscopy, X-ray ﬂuorescence, and X-ray microanalysis suggest that a stone tool was used. The results of macroscopic and CT analysis suggest that the surgery was motivated by the exacerbation of chronic periodontal disease and probably by caries. The left third molar was extracted without complications 2–3 months before the individual’s death. On the right side, the pathological process continued, culminating in osteomyelitis and its complications. The surgeon’s skill notwithstanding, the extraction of the right third molar did not cure the patient, who died, apparently following the destructive stage of acute osteomyelitis complicated by orofacial phlegmon. Our ﬁndings suggest that the level of dental surgery practiced in the Inca Empire was ahead of the diagnostic expertise.

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IgD (kappa) "nonsecretory" multiple myeloma: report of a case

Blood ◽

10.1182/blood.v56.5.898.bloodjournal565898 ◽

1980 ◽

Vol 56 (5) ◽

pp. 898-901

Author(s):

C Bartoloni ◽

G Flamini ◽

C Logroscino ◽

L Guidi ◽

F Scuderi ◽

...

Keyword(s):

Multiple Myeloma ◽

Plasma Cells ◽

Protein Electrophoresis ◽

Lytic Lesion ◽

Normal Amount ◽

Left Femur ◽

Osteolytic Lesions ◽

Normal Bone ◽

Single Clone ◽

Scintigraphic Study

A case of IgD “nonsecretory” multiple myeloma in a 46-yr-old woman is reported. Despite the presence of disseminated osteolytic lesions, both serum protein electrophoresis and serum and urine immunoelectrophoresis were normal. In addition, bone scintigraphic study was normal. Bone marrow biopsy and aspirate obtained from the left femur lytic lesion showed only myelomatous proplasmocytes; when examined by immunofluorescence with monospecifc antisera, the cytoplasm showed only the presence of delta and kappa chains, suggesting that the neoplastic plasma cells might belong to a single clone. Lymphocyte studies indicated the presence of a normal amount of both B and T cells.

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