Plasmacytoma and plasma cell myeloma affecting the jaws: A multi-institutional collaborative study

Lucas Lacerda de Souza, Cinthia Verónica Bardález López de Cáceres, Pablo Agustin Vargas, Márcio Ajudarte Lopes, Alan Roger Santos-Silva, Wagner Gomes da Silva, Ana Carolina Prado-Ribeiro, Thais Bianca Brandão, Juliana Pereira, Ricardo Alves Mesquita, Flávia Sirotheau Correa Pontes, Wilfredo Alejandro González-Arriagada, Ricardo Martinez Pedraza, Bruno Augusto Benevenuto de Andrade, Mario José Romañach, Ciro Dantas Soares, Maria Goretti Freire de Carvalho, Fabio Ramôa Pires, Roman Carlos, Felipe Paiva FonsecaHélder Antônio Rebelo Pontes, Oslei Paes de Almeida

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Plasma cell neoplasms are characterized by the proliferation of a single clone of plasma cells with production of a monoclonal immunoglobulin. They can manifest as a single lesion (plasmacytoma) or as multiple lesions (multiple myeloma).

METHODS: Paraffin-embedded tissue blocks of patients microscopically diagnosed with plasma cell neoplasms in the jaws were retrieved from five pathology files. Data including clinical, radiographic, microscopic and immunohistochemical findings, treatment employed and follow-up status were retrieved from the pathology reports.

RESULTS: Fifty-two cases were retrieved (mean age: 59.4 years) without sex predilection. The mandible was the most affected site (67.3%), usually associated with pain and/or paresthesia (53.8%). Lesions in other bones besides the jaws were reported for 24 patients (46.2%). Radiographically, tumours usually presented as poorly defined osteolytic lesions with unilocular or multilocular images, while microscopy revealed diffuse proliferation of neoplastic plasma cells with nuclear displacement and abundant eosinophilic cytoplasm. Two cases were classified as anaplastic, and amyloid deposits were found in two other cases. Immunohistochemistry was positive for plasma cell markers and negative for CD20 and CD3, and monoclonality for kappa light chain predominated. The overall survival rate after 5 years of follow-up was 26.6%.

CONCLUSION: Plasma cell neoplasms are aggressive tumours with a poor prognosis and involvement of the jaws may be the first complaint of the patient. Thus, oral pathologists, head and neck surgeons and dentists should be aware of their clinical, radiographic and microscopic manifestations.

Original languageEnglish
Pages (from-to)613-621
Number of pages9
JournalJournal of Oral Pathology and Medicine
Volume50
Issue number6
DOIs
StatePublished - Jul 2021

Bibliographical note

© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Keywords

  • Humans
  • Immunohistochemistry
  • Jaw/diagnostic imaging
  • Middle Aged
  • Multiple Myeloma/diagnostic imaging
  • Neoplasms, Plasma Cell/diagnostic imaging
  • Plasmacytoma/diagnostic imaging

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