Tooth Extraction Locally Stimulates Proliferation of Multiple Myeloma in a Patient with Mandibular Localizations

TitreTooth Extraction Locally Stimulates Proliferation of Multiple Myeloma in a Patient with Mandibular Localizations
Type de publicationArticle de revue
AuteurKün-Darbois, Jean-Daniel , Quenel, Léonie, Badja, Smaïl, Chappard, Daniel
EditeurKarger Publishers
TypeArticle scientifique dans une revue à comité de lecture
Titre de la revueActa haematologica
Mots-clésBisphosphonate-Associated Osteonecrosis of the Jaw, Bone Density Conservation Agents, Cell Proliferation, Female, Humans, mandible, Middle Aged, Multiple myeloma, Periodontitis, Plasma Cells, Tooth Extraction
Résumé en anglais

OBJECTIVES: Multiple myeloma (MM) is characterized by the occurrence of osteolytic lesions. MM treatment usually involves antiresorptive drugs (mainly bisphosphonates).

CASE REPORT: A patient with an MM presented osteolytic lesions of the mandible. Extraction of teeth 45 and 46 was performed 5 years after the diagnosis of periodontitis. Four months later, osteonecrosis of the jaw (ONJ) was diagnosed at the extraction site. X-ray showed an extension of osteolytic lesions on the right side, close to the extraction site, without modification of the lesions on the left side. Two months later, a curettage was performed because of a painful bone sequestration. X-ray showed an extension of the osteolytic lesions on the right side.

RESULTS: Histological analysis found a vascularized plasmacytoma of the soft tissues around the ONJ. Analysis of the bone showed mixed lesions with osteonecrotic areas and living bone resorbed by active osteoclasts surrounding a plasmacytoma. The surface area of the osteolytic foci has considerably increased only close to the extraction site.

CONCLUSIONS: Tooth extraction triggered an ONJ associated with bisphosphonate treatment. However, it also seemed to induce a considerable proliferation of plasma cells at the extraction site; we hypothesize that it is due to the increase in bone remodeling related to the surgical trauma.

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Titre abrégéActa Haematol.
Identifiant (ID) PubMed29207391