The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
권호 표지

Multiple myeloma: Report of two cases with emphasis on the panoramic imaging features

파노라마방사선영상에서 관찰되는 다발골수종: 증례보고

  • Yeom, Han-Gyeol (Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University)
  • 염한결 (서울대학교 치의학대학원 영상치의학교실)
  • Received : 2018.11.01
  • Accepted : 2018.11.13
  • Published : 2018.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Multiple myeloma is a lymphohematopoietic disorder leading to abnormal hemostasis and significant pathologic changes of skeletal system. It induces multiple circular or oval-shaped radiolucent lesions which are characterized by 'punched-out appearance'. The surrounding trabecular bone normally shows no significant sclerotic reaction. Multiple myeloma patients may visit dental clinics, without perception of the disease themselves, due to discomfort from edema of orofacial region, oral ulcers, tooth mobility, pain or gingival bleeding. Multiple myeloma is susceptible to various complications, including delayed hemostasis and infection, which could occur during routine dental treatment such as periodontal and surgical operation. For radiographic diagnosis of multiple myeloma, common radiologic features of this tumor could be visualized by panoramic radiographs in the dental clinics, and further medical examinations and treatment can be recommended as a result.

Keywords

References

  1. Kumar SK, Callander NS, Alsina M, Atanackovic D, Biermann JS, Castillo J, et al. Multiple Myeloma, version 3.2018: Featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2018; 16: 11-20. https://doi.org/10.6004/jnccn.2018.0002
  2. Durie BGM, Harousseau JL, Miguel JS, Blad? J, Barlogie B, Anderson K, et al. International uniform response criteria for multiple myeloma. Leukemia. 2006; 20: 1467-73. https://doi.org/10.1038/sj.leu.2404284
  3. Witt C, Borges AC, Klein K, Neumann H-J. Radiographic manifestations of multiple myeloma in the mandible: A retrospective study of 77 patients. J Oral Maxillofac Surg. 1997; 55: 450-3. https://doi.org/10.1016/S0278-2391(97)90687-X
  4. Furutani M, Ohnishi M, Tanaka Y. Mandibular involvement in patients with multiple myeloma. J Oral Maxillofac Surg. 1994; 52: 23-5. https://doi.org/10.1016/0278-2391(94)90007-8
  5. Mozaffari E, Mupparapu M, Otis L. Undiagnosed multiple myeloma causing extensive dental bleeding: Report of a case and review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94: 448-53. https://doi.org/10.1067/moe.2002.125201
  6. Kumar SK, Callander NS, Alsina M, Atanackovic D, Biermann JS, Castillo J, et al. NCCN Guidelines Insights: Multiple Myeloma, Version 3.2018. J Natl Compr Canc Netw 2018; 16: 11-20. https://doi.org/10.6004/jnccn.2018.0002
  7. Chang H, Li D, Zhuang L, Nie E, Bouman D, Stewart AK, et al. Detection of chromosome 13q deletions and IgH translocations in patients with multiple myeloma by FISH: comparison with karyotype analysis. Leukemia Lymphoma. 2004; 45: 965-9. https://doi.org/10.1080/10428190310001638832
  8. Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos M-V, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014; 15: e538-e48. https://doi.org/10.1016/S1470-2045(14)70442-5
  9. Woolfenden JM, Pitt MJ, Durie B, Moon TE. Comparison of bone scintigraphy and radiography in multiple myeloma. Radiol. 1980; 134: 723-8. https://doi.org/10.1148/radiology.134.3.7355226
  10. Attal M, Harousseau J-L, Stoppa A-M, Sotto J-J, Fuzibet J-G, Rossi J-F, et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. N Engl J Med. 1996; 335: 91-7. https://doi.org/10.1056/NEJM199607113350204
  11. Jadu F, Lee L, Pharoah M, Reece D, Wang L. A retrospective study assessing the incidence, risk factors and comorbidities of pamidronate-related necrosis of the jaws in multiple myeloma patients. Ann Oncol. 2007; 18: 2015-9. https://doi.org/10.1093/annonc/mdm370
  12. Leigh BR, Kurtts TA, Mack CF, Matzner MB, Shimm DS. Radiation therapy for the palliation of multiple myeloma. Int J Radiat Oncol Biol Phy. 1993; 25: 801-4. https://doi.org/10.1016/0360-3016(93)90308-I