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Pathologic Mandibular Fracture as the Presenting Manifestation of Multiple Myeloma

Boffano, Paolo MD*; Viterbo, Stefano MD, DDS*; Barreca, Antonella MD; Berrone, Sid MD, DDS*

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1312-1315
doi: 10.1097/SCS.0b013e31821c6cbe
Clinical Studies
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The authors report on the management of a patient who presented with a pathologic mandibular fracture as the initial presenting sign of multiple myeloma. The patient underwent surgical resection of the mandibular area involved by the pathologic fracture and osteolytic lesion. Then, he was prescribed combined thalidomide, melphalan, and prednisone for systemic treatment. The patient tolerated his treatment well and is currently being followed up on outpatient basis. The treatment of a mandibular pathologic fracture associated with a solitary multiple myeloma lesion should include a segmental resection of the mandibular bone that is involved by the lesion. An appropriate reconstruction can be immediately performed or delayed. Anyway, the importance of an early beginning of systemic treatment should always be remembered.

From the *Division of Maxillofacial Surgery, Head and Neck Department and †Division of Pathology, Department of Biomedical Sciences and Human Oncology, San Giovanni Battista Hospital, University of Turin, Turin, Italy.

Received June 27, 2010.

Accepted for publication August 1, 2010.

Address correspondence and reprint requests to Paolo Boffano, MD, Maxillofacial Surgery Unit, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy; E-mail: paolo.boffano@gmail.com

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD