Extramedullary Plasmacytomas of the Oral Cavity: A Case Report and Review of the Literature

  • Roxanne Bavarian Division of Orofacial Pain Medicine, Department of Surgery, Massachusetts General Hospital, Boston, United States
  • Nathaniel Treister Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine and Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Boston, United States
Keywords: multiple myeloma, oral plasmacytoma, extramedullary plasmacytoma, oral tumor

Abstract

Abstract

Introduction: Multiple myeloma is a hematologic malignancy characterized by the proliferation of plasma cells and typically presents with lesions in bone, known as plasmacytomas. Through hematogenous spread, extramedullary plasmacytomas can develop in soft tissue in any location of the body. This case report describes a patient with multiple myeloma who presented with an extramedullary plasmacytoma on his maxillary gingiva and provides an updated review on the classification and characterization of extramedullary plasmacytomas of the oral cavity. 
Case description: A 53-year-old male with a known diagnosis of multiple myeloma was referred to our clinic for evaluation of a gingival nodule, which was tender to palpation and had been present for a month. Clinical examination revealed a 1.5 cm violaceous, red nodule of the maxillary buccal attached gingiva, which did not blanch on palpation. He had a similar 1 cm, smooth, red nodule of his cutaneous skin on his left arm. Radiographic examination with within normal limits without evidence of dental or bony pathology. An incisional biopsy revealed the diagnosis of plasmacytoma, indicating relapse and progression of the patient’s multiple myeloma.
Practical implications: Multiple myeloma can present in the oral cavity either as intra-bony plasmacytomas, paraskeletal plasmacytomas, or extramedullary plasmacytomas in the soft tissue. Extramedullary disease representative of hematogenous spread is concerning for high-risk disease with a poor risk prognosis.

Published
2021-06-25
How to Cite
1.
Bavarian R, Treister N. Extramedullary Plasmacytomas of the Oral Cavity: A Case Report and Review of the Literature. J Cancer Allied Spec [Internet]. 2021Jun.25 [cited 2021Dec.2];7(2). Available from: https://journals.sfu.ca/jcas/index.php/jcas/article/view/417