Diagnosis of multiple myeloma by the dental surgeon: case report

Abstract

Objective: multiple myeloma is a progressive malignancy
of B cells, characterized by unregulated
and clonal proliferation of plasma cells in the
bone marrow. The present work aims to describe
a clinical case of multiple myeloma diagnosed by
the dentist. Case description: a 60-year-old female
patient attended the Dentistry School of the State
University of Feira de Santana, Bahia, Brazil,
whose main complaint was: “I feel a pain inside
my mouth, it seems that my mouth has loosened”.
In the history of the current disease, the patient
reported that, approximately 2 months ago, when
chewing hard food, she noticed a click and that
since then the sensation was of a dislocation of the
temporomandibular joint, but with mild painful
symptoms. In medical history it has been reported
that for 3 years it has been showing signs of bone
pain, lethargy, dysphagia, anemia, weight loss and
chronic malaise. On physical examination, an inlimitescrease in volume was observed in the region of
the left mandibular body and in the right collarbone.
On intraoral physical examination, a small
increase in volume was observed in the left side
of the mandible. Imaging exams were requested
and an incisional biopsy was performed. In view
of the clinical, imaging and histological picture,
the diagnosis of multiple myeloma was reached.
Conclusion: it is extremely important to know
the epidemiological clinical behavior of multiple
myeloma in order to make a timely, comprehensive
and early diagnosis, with the aim of improving
the patient’s prognosis and survival.