Multiple Myeloma with Multimodular Appearance in the Mandible: A Case Report with Radiographic Findings

Abstract

Objective: Multiple myeloma (MM) is a malignant disease characterized by plasma cells producing abnormal immunoglobulin in the bone marrow. It usually gives a radiolucent image in the form of a punch hole with good borders in cortical structure devices in the mandible. The purpose of this case report is to present a mandibular lesion with different radiographic findings in a patient with MM. Case Report: A 49-year-old male patient diagnosed with MM and scheduled for bisphosphonate treatment applied to the Oral and Maxillofacial Radiology clinic. In the panoramic radiograph, a lobulated, well-circumscribed, multilocular radiolucent area involving the apices of the 2nd and 3rd molars and the inferior alveolar canal in the left mandibular angulus region, causing root resorption in the 3rd molar, and a well-circumscribed staple-hole-looking radiolucent lesion in the middle part of the ramus were observed. In the patient's current computed tomography (CT) images, a lobulated, poorly-circumscribed, homogeneous, hypodense bone lesion was observed in the mandibular ramus region, showing mild expansion, thinning and occasionally destroying the buccal and lingual cortical bone. In the magnetic resonance (MR) images, isointense, weakly-circumscribed lesions were observed in the left mandibular ramus region, causing bone destruction, and muscle-related weakly-circumscribed lesions. Conclusion: Clinicians should also consider MM lesions in the differential diagnosis of cystic or multiloculated lesions in the mandible. © 2024, Selcuk University. All rights reserved.