Generalized gingival hyperplasia as a late manifestation of multiple myeloma: a case report

Abstract

Objective: This study aims to present a clinical case of Multiple Myeloma (MM) with an unusual oral presentation, highlighting the importance of oral surveillance in the comprehensive diagnosis of hematological diseases.

Clinical case: The case of a 70-year-old female patient who attended the Department of Stomatology "A" of the Faculty of Dentistry (Universidad Nacional de Córdoba) with bimaxillary gingival lesions of 6 months of evolution is presented. The patient, with no known medical history, presented significant weight loss and severe systemic symptoms. On clinical examination, painful gingival hyperplastic masses were observed, with generalized tooth mobility. Orthopantomography and tomography revealed alveolar resorption and osteolytic areas. Laboratory tests showed anemia, leukopenia, thrombocytopenia, and elevated inflammatory markers. The biopsy revealed a proliferation of monoclonal plasma cells positive for CD38 and kappa chains, leading to the diagnosis of MM. The patient was referred to oncohematology, but died quickly.

Conclusion: This case highlights the importance of early recognition of oral manifestations of MM, which can be a diagnostic challenge due to their similarity to other common oral conditions. Timely identification of these lesions by dentists may be crucial to reduce the morbidity and mortality associated with this hematological disease.