Recurrence of multiple myeloma in the mandible mimicking endodontic lesion: a case report

Multiple myeloma is a widespread malignant neoplasm that affects plasma cells. Although the involvement of the maxillofacial region is uncommon, it can involve the dental apexes. The aim of this study is to describe a clinical case of recurrent multiple myeloma that mimicked endodontic lesions. A 75-year-old female patient sought emergency dental care due to an increase in volume in the mandible, in the region of teeth 44 and 45, similar to odontogenic cellulite. Emergency dental treatment of tooth 45 was performed, followed by subsequent computed tomography and incisional biopsy, due to a previous diagnosis of multiple myeloma. The image examination revealed an osteolytic lesion involving the apex of teeth 44 and 45. Histological examination showed proliferation of cells with plasmacytoid morphology and atypia, which invaded the connective tissue, confirming a diagnosis of recurrent multiple myeloma. The patient was referred for cancer treatment and has been stable up to the present day. (C) 2020 Sociedade Portuguesa de Estomatologia e Medicina Dentaria.