Multiple Myeloma: Concise Review of the Literature and A Case Report of Mandibular Involvement

Multiple myeloma is an uncommon hematologic malignancy which is characterized by monoclonal proliferation of malignant plasma cells. The most common locations include the spine, skull, pelvis, ribs, humerus, femur and jaws. Jaw involvement usually present as secondary lesions. The prevalence of jaw involvement is up to 30%, more commonly involving the mandible. Diagnostic techniques used to evaluate patients with suspected multiple myeloma include bone marrow biopsy, blood tests, urinalysis and radiographic evaluation. For most patients, the preferred treatment option is for induction chemotherapy followed by autologous stem cell transplantation. Bisphosphonates are commonly used in the treatment of multiple myeloma as they inhibit bone resorption and exert anti-tumor activity. Patients are usually referred to the dental service for clearance prior to commencement of intravenous bisphosphonate therapy. We present a case report which describes the incidental finding and subsequent management of a secondary lesion at the left mandible in a patient diagnosed with multiple myeloma during a routine dental examination. The necessity for dental clearance prior to bisphosphonate therapy makes it necessary to treat jaw lesions for Multiple Myelomas which were previously monitored and treated medically along with the Myeloma.