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Article dans une revue

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

Abstract :

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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https://hal.univ-angers.fr/hal-02869263
Contributeur : Okina Université d'Angers <>
Soumis le : lundi 15 juin 2020 - 20:39:52
Dernière modification le : mardi 16 juin 2020 - 03:51:13

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Jean-Daniel Kün-Darbois, Léonie Quenel, Smaïl Badja, Daniel Chappard. Tooth Extraction Locally Stimulates Proliferation of Multiple Myeloma in a Patient with Mandibular Localizations. Acta haematologica, 2017, 138, pp.201-207. ⟨10.1159/000481425⟩. ⟨hal-02869263⟩

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