Refractory multiple myeloma presenting as oral gingival mass

Abstract

Multiple myeloma (MM) is a disseminated multifocal hematologic malignancy characterized by the proliferation of a single clone of abnormal plasma cells in the bone marrow (BM) and/or extramedullary sites. Maxillofacial manifestations in patients with MM are common but frequently misdiagnosed. In the present case, a 65-year-old male with MM presented with a maxillary gingival mass lesion on the left side of the oral cavity. Fine-needle aspiration cytology (FNAC) and microscopic nodule examination revealed tumor cells (plasmablasts). Being vigilant about oral metastatic lesions in a known case of MM suggested starting a workup for MM relapse, and subsequent BM workup and serum immunofixation confirmed MM relapse. This case emphasized the oral cavity lesions in the known case of MM, the utility of the FNAC, and an interdisciplinary approach to such lesions for early diagnosis and initiation of treatment.