MULTIPLE MYELOMA MIMIKINGADVANCED PERIODONTAL DISEASE

Multiple myeloma (MM) is a malignant hematologic disease characterized by the multicentric proliferation of plasma cells in the bone marrow. A 58-year-old male patient was referred with complaint of swelling on the anterior mandible associated with bleeding, dental mobility, and difficulty in using partial inferior prosthesis. The initial clinical diagnosis was advanced periodontal disease. The radiographic examination revealed extensive osseous bone resorption and fluctuation of anterior teeth. After biopsy, the microscopic examination revealed malignant neoplasia composed by monotonous plasmacytoid cells with a variable degree of maturation. The neoplastic cells presented intense pleomorphism, prominent nucleolus, and hyaline inclusions. The immunohistochemical analyses showed positivity of the neoplastic cells for CD45, CD138, Kappa, and Ki-67 (5% to 10%). There was negativity for cytokeratin (CK-pool), CD20, and lambda. The final diagnosis of MM was given. The patient has been undergoing chemotherapy and followed-up by the multidisciplinary team.