下顎骨病的骨折を契機に診断し得た多発性骨髄腫の1例

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A case of multiple myeloma of the in mandible is reported. A 67-year-old man presented to our hospital with discomfort caused by a denture in October 2005. There was a bony edge at the left molar region of the mandible, and radiographs showed a 6-cm osteolytic lesion and a fracture line in the left side of the mandible. Osteolytic lesions were also observed in the right side of the mandible and right temporal bone. A computed tomographic scan of the chest and abdomen revealed diffuse osteolytic changes and fracture lines in the spinal bones. There was increased uptake in the 9th and 12th thoracic vertebrae and the mandible on bone scintigraphy. However, little uptake was found in the region of the tumor. Laboratory tests revealed elevations of protein and IgG levels, accompanied by anemia. Renal failure and Bence-Jones proteinurea were not apparent. M-protein was positive in the urine. Bone marrow aspiration revealed 30 % plasma cells, and immunoelectrophoresis showed that an IgG band with a κ light chain. IgG-κ type multiple myeloma was diagnosed. In the department of hematological medicine, 2 courses of VAD (vincristine, adriamycin, dexamethasone) chemotherapy were administered, followed 20 courses of MP (melphalan, prednisolone) chemotherapy in the outpatient clinic. After chemotherapy, a complete response was achieved in the hematological findings, the fractured mandible healed, and the osteolytic lesions decreased. Tumor recurrence has not occurred for 2 years after VAD therapy.
Japanese Society of Oral and Maxillofacial Surgeonsの論文

下顎骨病的骨折を契機に診断し得た多発性骨髄腫の1例

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