抜歯後治癒不全を契機に発見され多発性骨髄腫へと移行した上顎骨孤立性形質細胞腫の1例

• Published in: 日本口腔外科学会雑誌 Vol. 69; no. 12; pp. 555 - 561
• Main Authors: 田尻, 祐大, 吉川, 博政, 吉田, 将律, 永井, 清志, 沖永, 耕平, 山口, 豊
• Format: Journal Article
• Language: Japanese
• Published: 公益社団法人 日本口腔外科学会 20.12.2023
• Subjects: 上顎骨; 多発性骨髄腫; 孤立性形質細胞腫; 放射線療法
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.69.555

Solitary plasmacytoma is a disease characterized by monoclonal proliferation of plasma cells. It frequently occurs in the spine or femur but rarely in the maxilla. We herein report a case of solitary plasmacytoma of the maxilla that was discovered in association with poor wound healing after tooth extraction and progressed to multiple myeloma. A 72-year-old man was referred to our department for continuous pain after tooth extraction. We found a 15×10 mm mass with a smooth surface in the right upper first molar region. Incisional biopsy resulted in a histopathological diagnosis of plasmacytoma. Since there were no abnormal findings upon general examination in the hematology department, we made a definitive diagnosis of solitary plasmacytoma of the maxilla. The patient received local radiotherapy, and the tumor completely regressed. Although there was no evidence of local recurrence after one year and four months, laboratory analysis indicated remarkably high levels of IgG, and we therefore suspected the tumor would transform into multiple myeloma. After an eight-month hiatus, the patient revisited the hematology department, where PET-CT revealed multiple bone lesions and a diagnosis of multiple myeloma was made. We recommended chemotherapy, however the patient declined and elected for best supportive care.