Multiple Myeloma Presenting as Mandibular Ill-Defined Radiolucent Lesion With Numb Chin Syndrome: A Case Report Husam G. Elias, MD, DMD, Jacob Scott,

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Presentation transcript:

Multiple Myeloma Presenting as Mandibular Ill-Defined Radiolucent Lesion With Numb Chin Syndrome: A Case Report Husam G. Elias, MD, DMD, Jacob Scott, MD, Leland Metheny, MD, Faisal A. Quereshy, MD, DDS Journal of Oral and Maxillofacial Surgery Volume 67, Issue 9, Pages 1991-1996 (September 2009) DOI: 10.1016/j.joms.2009.04.016 Copyright © 2009 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 1 Neck CT scan showing left-sided osteolytic lesion. Elias et al. Multiple Myeloma With Radiolucent Lesion. J Oral Maxillofac Surg 2009. Journal of Oral and Maxillofacial Surgery 2009 67, 1991-1996DOI: (10.1016/j.joms.2009.04.016) Copyright © 2009 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 2 Panoramic radiograph showing an ill-defined unilocular radiolucency extending anteriorly to the premolar region, scalloped around premolar roots without resorption; it also spares the lower border of the mandible. Elias et al. Multiple Myeloma With Radiolucent Lesion. J Oral Maxillofac Surg 2009. Journal of Oral and Maxillofacial Surgery 2009 67, 1991-1996DOI: (10.1016/j.joms.2009.04.016) Copyright © 2009 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 3 Cone beam CT scan of mandibular lesion, showing 3-dimensional reconstruction of the lesion as well as extension into the anteroposterior axial, sagittal, and coronal sections. Elias et al. Multiple Myeloma With Radiolucent Lesion. J Oral Maxillofac Surg 2009. Journal of Oral and Maxillofacial Surgery 2009 67, 1991-1996DOI: (10.1016/j.joms.2009.04.016) Copyright © 2009 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 4 Incisional biopsy specimen of mandibular lesion. Elias et al. Multiple Myeloma With Radiolucent Lesion. J Oral Maxillofac Surg 2009. Journal of Oral and Maxillofacial Surgery 2009 67, 1991-1996DOI: (10.1016/j.joms.2009.04.016) Copyright © 2009 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 5 The photomicrographs show sheets of rather uniform medium-sized round/oval cells with eccentric nuclei, inconspicuous nucleoli, and abundant eosinophilic cytoplasm with a peri-nuclear halo. A rare binucleated cell is noted. No organoid arrangement is seen. (H&E stain.) Elias et al. Multiple Myeloma With Radiolucent Lesion. J Oral Maxillofac Surg 2009. Journal of Oral and Maxillofacial Surgery 2009 67, 1991-1996DOI: (10.1016/j.joms.2009.04.016) Copyright © 2009 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 6 Osteolytic lesions of humerus and femoral neck. Elias et al. Multiple Myeloma With Radiolucent Lesion. J Oral Maxillofac Surg 2009. Journal of Oral and Maxillofacial Surgery 2009 67, 1991-1996DOI: (10.1016/j.joms.2009.04.016) Copyright © 2009 American Association of Oral and Maxillofacial Surgeons Terms and Conditions