PDF(Pubmed)
Abstract：
Non-secretory multiple myeloma (NSMM) is a rare cancer of plasma cells characterized by the absence of detectable monoclonal M protein in the blood or urine. A 57-year-old woman presented with mandibular pain but without intraoral swelling. Imaging studies revealed multiple osteolytic lesions in her mandible and pronounced root resorption of the left mandibular second molar. Biopsy results showed atypical plasmacytoid cells positive for anti-kappa, CD138, MUM1, and CD79a antibodies, but negative for anti-lambda and CD20. These results were indicative of a malignant plasma cell neoplasm. No abnormalities were revealed by free light chain assay or by serum or urine protein electrophoresis, leading to a diagnosis of NSMM. The patient began chemotherapy in conjunction with bisphosphonate therapy and achieved remission following treatment. This case underscores the critical role of dentists in the early detection and prevention of NSMM complications, as the disease can initially present in the oral cavity.
摘要：
非分泌性多发性骨髓瘤（NSMM）是一种罕见的浆细胞癌，其特征是血液或尿液中缺乏可检测的单克隆M蛋白。一名57岁的女性出现下颌疼痛，但没有口腔肿胀。影像学检查显示，她的下颌骨有多处溶骨性病变，左下颌第二磨牙的根部吸收明显。活检结果显示非典型浆细胞样细胞抗κ阳性，CD138、MUM1和CD79a抗体，但抗λ和CD20阴性。这些结果表明恶性浆细胞肿瘤。通过游离轻链测定或通过血清或尿蛋白电泳未发现异常，导致NSMM的诊断。患者开始化疗联合双膦酸盐治疗，并在治疗后获得缓解。这一案例强调了牙医在早期发现和预防NSMM并发症方面的关键作用，因为这种疾病最初可以出现在口腔中。
