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題名 | Multiple Myeloma with Primary Manifestation in Mandible--A Case Report=下顎骨為第一表徵之多發性骨髓瘤--病例報告 |
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作者姓名(中文) | 林立綺; 何祖銘; 林煥章; | 書刊名 | 臺灣口腔顎面外科學會雜誌 |
卷期 | 25:2 2014.06[民103.06] |
頁次 | 頁127-136 |
分類號 | 416.954 |
關鍵詞 | 多發性骨髓瘤; 漿細胞瘤; Multiple myeloma; Plasmacytoma; |
語文 | 英文(English) |
中文摘要 | 多發性骨髓瘤是一種骨髓中過度增生的單株漿細胞的血液疾病,這些漿細胞會造成所在位置的骨頭破壞以及骨頭疼痛。多發性骨髓瘤發生在口腔表徵的機率約百分之三十,但以口腔為第一表徵的則很少見。本文案例是一名五十五歲女性,來院主訴右臉腫脹。環口攝影顯示於右下顎骨有骨溶解病灶,範圍往後延伸到冠狀突和下頓骨上升支。經由骨髓切片,血液檢查和影像檢查確診為多發性骨髓瘤。後續接受緩解性放射治療和化學治療。右臉腫脹消減,右下顎骨骨新生,免疫蛋白A下降,顯示病人接受治療後狀況穩定。本文強調口腔顎面外科醫師藉由口腔病灶檢察來懷疑或確診多發性骨髓瘤,以期達到早期診斷和後續良好預後。 |
英文摘要 | Multiple myeloma (MM) is a hematological disease characterized by monoclonal proliferation of plasma cells in the bone marrow, which causes osteolytic lesions and one of the common clinical manifestations: bone pain. The incidence in oral cavity was about 30%, but as a primary manifestation the chance is low. This paper reports a case of 55 years old female with painless swelling in the right face as chief complaint. Radiographic image revealed an osteolytic lesion in right posterior mandible with ill-defined margin extending to coronoid process and mandibular ascending ramus. Multiple myeloma was diagnosed via bone marrow biopsy, blood examination and image finding. Palliative radiotherapy was followed by chemotherapy. Improvement of right facial swelling, new bone formation in right mandible, decrease of IgA indicated that patient was in a stable condition after the treatment. This case report highlights the important role of oral surgeon for acknowledging maxillofacial manifestations in multiple myeloma since early diagnosis may lead to better prognosis. |
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