melphalan and Mandibular-Neoplasms

The authors reported a case of a solitary mandibular plasmacytoma in a 53-year-old male Caucasian patient. The histological examination of the specimen was positive for a plasmacytoma with anaplastic appearance. Since the patient refused a demolitive surgical treatment, he was treated with a local radiation therapy of 4000 rads over a 20-day period and polychemotherapy with cyclophosphamide, prednisone and melphalan. Six years after starting radiation treatment the patient is free of recurrent primary disease and not affected by multiple localization. In conclusion, the solitary bone plasmacytoma represents an initial stage of the multiple myeloma rather than a distinct clinical pathology. Unfortunately, the diagnosis of the plasmacytoma is only rarely carried out in the early phases of the disease. The importance of the identification of the initial stage without a clear M component, as in the reported case, is self-evident, since the prognosis is related to the mass of plasmacytoma cells that are present at the time of the diagnosis. The purpose of this study is to report an extremely rare case of solitary bone plasmacytoma with a mandibular localization treated with radio- and polychemotherapy.

Topics: Antineoplastic Agents, Alkylating; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Cyclophosphamide; Follow-Up Studies; Humans; Male; Mandibular Neoplasms; Melphalan; Middle Aged; Plasmacytoma; Prednisone; Prognosis; Radiotherapy Dosage; Remission Induction

We report here the youngest known IgM myeloma patient to have presented with a mandibular mass. A 22-year-old Chinese man sought medical attention due to a mass over his right mandible that had been growing progressively for 6 months. A solitary osteolytic lesion in the right mandible was identified radiologically. Incisional biopsy revealed the presence of plasma cells of monoclonal origin, as evidenced by the exclusively positive staining of the kappa light chain. The diagnosis of multiple myeloma with mandibular involvement was confirmed by bone marrow examination. Further tests, including immunoglobulin electrophoresis and assay of the serum levels of kappa and lambda light chains, demonstrated that his myeloma was of the IgM, kappa subtype. The patient achieved a nonsustained partial response to six courses of melphalan and prednisolone therapy and palliative radiotherapy.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Humans; Immunoglobulin kappa-Chains; Immunoglobulin M; Male; Mandibular Neoplasms; Melphalan; Multiple Myeloma; Myeloma Proteins; Osteolysis; Palliative Care; Prednisolone

Topics: Age Factors; Antineoplastic Combined Chemotherapy Protocols; Diagnosis, Differential; Female; Humans; Mandibular Neoplasms; Mandibular Nerve; Melphalan; Middle Aged; Multiple Myeloma; Paresthesia; Prednisone; Radiography; Sex Factors

Topics: Adolescent; Adult; Aged; Bone Neoplasms; Child; Child, Preschool; Cyclophosphamide; Doxorubicin; Drug Therapy, Combination; Female; Femoral Neoplasms; Follow-Up Studies; Frontal Bone; Humans; Humerus; Ilium; Male; Mandibular Neoplasms; Maxillary Neoplasms; Melphalan; Middle Aged; Neoplasm Metastasis; Osteosarcoma; Radiotherapy, High-Energy; Sacrum; Sphenoid Bone; Tibia; Vincristine

Topics: Female; Fractures, Spontaneous; Humans; Mandibular Neoplasms; Melphalan; Middle Aged; Plasmacytoma

Topics: Adolescent; Alkylating Agents; Antineoplastic Agents; Aziridines; Black People; Burkitt Lymphoma; Child; Cyclophosphamide; Dactinomycin; Epidemiology; Humans; Kenya; Lymphoma; Mandibular Neoplasms; Maxillary Neoplasms; Melphalan; Neoplasms; Oncogenic Viruses

Topics: Carotid Arteries; Chemotherapy, Cancer, Regional Perfusion; Facial Neoplasms; Humans; Lip Neoplasms; Mandibular Neoplasms; Maxillary Neoplasms; Melphalan; Mouth Neoplasms; Neoplasms; Parotid Neoplasms; Thiotepa; Tongue Neoplasms

Topics: Bone Neoplasms; Cobalt Isotopes; Dactinomycin; Drug Therapy; Humans; Mandible; Mandibular Neoplasms; Melphalan; Methotrexate; Neoplasms; Osteomyelitis; Osteosarcoma; Pathology; Radiography; Radium; Sarcoma

Topics: Adolescent; Child; Geriatrics; Head and Neck Neoplasms; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mandibular Neoplasms; Maxillary Neoplasms; Melanoma; Melphalan; Multiple Myeloma; Neoplasms; Orbital Neoplasms; Plasmacytoma; Sarcoma; Sarcoma, Kaposi