1.Beyond the mouth: Uncovering non-secretory multiple myeloma through oral symptoms
Pedro Henrique Chaves ISAIAS ; Fábio Wildson Gurgel COSTA ; Pedro Henrique Gonçalves Holanda AMORIM ; Raul Anderson Domingues Alves DA SILVA ; Fabrício Bitu SOUSA ; Karuza Maria Alves PEREIRA ; Ana Paula Negreiros Nunes ALVES ; Mário Rogério Lima MOTA
Imaging Science in Dentistry 2024;54(2):211-220
Non-secretory multiple myeloma (NSMM) is a rare cancer of plasma cells characterized by the absence of detectable monoclonal M protein in the blood or urine. A 57-year-old woman presented with mandibular pain but without intraoral swelling. Imaging studies revealed multiple osteolytic lesions in her mandible and pronounced root resorption of the left mandibular second molar. Biopsy results showed atypical plasmacytoid cells positive for anti-kappa, CD138, MUM1, and CD79a antibodies, but negative for anti-lambda and CD20. These results were indicative of a malignant plasma cell neoplasm. No abnormalities were revealed by free light chain assay or by serum or urine protein electrophoresis, leading to a diagnosis of NSMM. The patient began chemotherapy in conjunction with bisphosphonate therapy and achieved remission following treatment. This case underscores the critical role of dentists in the early detection and prevention of NSMM complications, as the disease can initially present in the oral cavity.
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