Avaliação Radiográfica da Maxila e da Mandíbula de Pacientes Diagnosticados com Mieloma Múltiplo: Estudo Retrospectivo
DOI:
https://doi.org/10.32635/2176-9745.RBC.2022v68n2.2186Palavras-chave:
mieloma múltiplo/diagnóstico, mandíbula, maxila, radiografia panorâmica, diagnóstico por imagemResumo
Introdução: O mieloma múltiplo e caracterizado como uma neoplasia maligna plasmocitária com a proliferação anormal de plasmócitos clonais na medula óssea de etiologia desconhecida. Objetivo: Caracterizar os pacientes com mieloma múltiplo atendidos no Setor de Estômato-Odontologia e Prótese do INCA, por meio de dados sociodemográficos, clínicos, laboratoriais e radiográficos. Método: Estudo transversal retrospectivo de pacientes com diagnostico de mieloma múltiplo, no período de 2000 a 2018, que realizaram radiografia panorâmica no período do diagnóstico da doença. Os dados sociodemográficos e clinico-radiográficos da população em estudo foram coletados nos prontuários dos pacientes, armazenados em banco de dados, analisados de forma descritiva e submetidos ao teste não paramétrico X2 (qui-quadrado). Resultados: Na amostra final, foram totalizados 163 casos. A maioria era de homens (56,4%), brancos (55,8%), com idade ≤55 anos (54%), ensino fundamental incompleto (30,7%), não fumantes (54,6%) e não bebedores (54,6%). Havia lesões líticas em 46 pacientes (28,2%) com predileção pela mandíbula (82,6%; p=0,000). Houve maior frequência de margens parcialmente definidas (50,0%), não escleróticas (78,2%) e de aspecto unilocular (43,5%). Dos 46 pacientes que apresentaram lesão lítica maxilomandibular, 27 pacientes tinham >55 anos (p=0,042). Conclusão: Ha maior ocorrência de lesões ósseas na mandíbula quando comparada a maxila.
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Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941-53. doi: https://doi.org/10.1002/ijc.31937 DOI: https://doi.org/10.1002/ijc.31937
Ludwig H, Bolejack V, Crowley J, et al. Survival and years of life lost in different age cohorts of patients with multiple myeloma. J Clin Oncol. 2010;28(9):1599-605. doi: https://doi.org/10.1200/JCO.2009.25.2114 DOI: https://doi.org/10.1016/S1557-9190(11)70509-1
Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-48. doi: https://doi.org/10.1016/S1470-2045(14)70442-5 DOI: https://doi.org/10.1016/S1470-2045(14)70442-5
Palumbo A, Anderson K. Multiple myeloma. N Engl J Med. 2011;364:1046-60. doi: https://doi.org/10.1056/NEJMra1011442 DOI: https://doi.org/10.1056/NEJMra1011442
Harmer D, Falank C, Reagan MR. Interleukin-6 interweaves the bone marrow microenvironment, bone loss, and multiple myeloma. Front Endocrinol (Lausanne). 2019;9:788. doi: https://doi.org/10.3389/fendo.2018.00788 DOI: https://doi.org/10.3389/fendo.2018.00788
Vinayachandran D, Sankarapandian S. Multiple osteolytic lesions. J Clin Imaging Sci. 2013;3(Suppl 1):6. doi: https://doi.org/10.4103/2156-7514.117460 DOI: https://doi.org/10.4103/2156-7514.117460
Witt C, Borges AC, Klein K, et al. Radiographic manifestations of multiple myeloma in the mandible: a retrospective study of 77 patients. J Oral Maxillofac Surg. 1997;55(5):450-3. doi: https://doi.org/10.1016/s0278-2391(97)90687-x DOI: https://doi.org/10.1016/S0278-2391(97)90687-X
Roodman GD. Skeletal imaging and management of bone disease. Hematology Am Soc Hematol Educ Program. 2008;313-9. doi: https://doi.org/10.1182/asheducation-2008.1.313 DOI: https://doi.org/10.1182/asheducation-2008.1.313
Epstein JB, Voss NJ, Stevenson-Moore P. Maxillofacial manifestations of multiple myeloma. An unusual case and review of the literature. Oral Surg Oral Med Oral Pathol. 1984;57(3):267-71. doi: https://doi.org/10.1016/0030-4220(84)90182-8 DOI: https://doi.org/10.1016/0030-4220(84)90182-8
Vieira-Leite-Segundo A, Falcão MFL, Correia-Lins Filho R, et al. Multiple myeloma with primary manifestation in the mandible: a case report. Med Oral Patol Oral Cir Bucal. 2008;13(4):E232-4. Cited in: PubMed; PMID 18379446.
Mozaffari E, Mupparapu M, Otis L. Undiagnosed multiple myeloma causing extensive dental bleeding: report of a case and review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):448-53. doi: https://doi.org/10.1067/moe.2002.125201 DOI: https://doi.org/10.1067/moe.2002.125201
Lee SH, Huang JJ, Pan WL, et al. Gingival mass as the primary manifestation of multiple myeloma: report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82(1):75-9. doi: https://doi.org/10.1016/S1079-2104(96)80380-5 DOI: https://doi.org/10.1016/S1079-2104(96)80380-5
Yoshimura Y, Takada K, Kawai N, et al. Two cases of plasmacytoma in the oral cavity. Int J Oral Surg. 1976;5(2):82-91. doi: https://doi.org/10.1016/S0300-9785(76)80052-X DOI: https://doi.org/10.1016/S0300-9785(76)80052-X
Dimopoulos M, Terpos E, Comenzo RL, et al. International Myeloma Working Group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia. 2009;23(9):1545-56. doi: https://doi.org/10.1038/leu.2009.89 DOI: https://doi.org/10.1038/leu.2009.89
Kyle R, Rajkumar S. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leukemia. 2009;23(1):3-9. doi: https://doi.org/10.1038/leu.2008.291 DOI: https://doi.org/10.1038/leu.2008.291
Dimopoulos M, Kyle R, Fermand JP, et al. Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3. Blood. 2011;117(18):4701-5. doi: https://doi.org/10.1182/blood-2010-10-299529 DOI: https://doi.org/10.1182/blood-2010-10-299529
Bishay N, Petrikowski CG, Maxymiw WG, et al. Optimum dental radiography in bone marrow transplant patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87(3):375-9. doi: https://doi.org/10.1016/S1079-2104(99)70227-1 DOI: https://doi.org/10.1016/S1079-2104(99)70227-1
Hameed A, Brady JJ, Dowling P, et al. Bone Disease in multiple myeloma: pathophysiology and management. Cancer Growth Metastasis. 2014;7:33-42. doi: https://doi.org/10.4137/cgm.s16817 DOI: https://doi.org/10.4137/CGM.S16817
Derlin T, Bannas P. Imaging of multiple myeloma: current concepts. World J Orthop. 2014;5(3):272-82. doi: https://doi.org/10.5312/wjo.v5.i3.272 DOI: https://doi.org/10.5312/wjo.v5.i3.272
Rocha TG, Feitosa ÉF, Maiolino Â, et al. Imaginological characterization of multiple myeloma lesions of the jaws through cone-beam computed tomography. Oral Radiol. 2020;36(2):168-76. doi: https://doi.org/10.1007/s11282-019-00394-1 DOI: https://doi.org/10.1007/s11282-019-00394-1
Anthony JV, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med [Internet]. 2005 [cited 2020 July 15];37(5):360-3. Available from: http://www1.cs.columbia.edu/~julia/courses/CS6998/Interrater_agreement.Kappa_statistic.pdf
Rodrigues PC. Bioestatística. 2 ed. Rio de Janeiro: EDUFF; 2002.
Faria KM, Brandão TB, Silva WG, et al Panoramic and skull imaging may aid in the identification of multiple myeloma lesions. Med Oral Patol Oral Cir Bucal. 2018;23(1):e38-e43. doi: https://doi.org/10.4317/medoral.22123 DOI: https://doi.org/10.4317/medoral.22123
Nair B, Waheed S, Szymonifka J, et al. Immunoglobulin isotypes in multiple myeloma: laboratory correlates and prognostic implications in total therapy protocols. Br J Haematol. 2009;145(1):134-7. doi: https://doi.org/10.1111/j.1365-2141.2008.07547.x DOI: https://doi.org/10.1111/j.1365-2141.2008.07547.x
Hungria VT, Crusoe EQ, Quero AA, et al. Guidelines on the diagnosis and management of multiple myeloma treatment: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Project guidelines: Associação Médica Brasileira - 2012. Rev Bras Hematol Hemoter. 2013;35(3):201-17. doi: https://doi.org/10.5581/1516-8484.20130050 DOI: https://doi.org/10.5581/1516-8484.20130050
Amini B, Yellapragada S, Shah S, et al. State-of-the-art imaging and staging of plasma cell dyscrasias. Radiol Clin North Am. 2016;54(3):581-96. doi: https://doi.org/10.1016/j.rcl.2015.12.008 DOI: https://doi.org/10.1016/j.rcl.2015.12.008
Ryu D, Kim HJ, Joung JG, et al. Comprehensive genomic profiling of IgM multiple myeloma identifies IRF4 as a prognostic marker. Oncotarget. 2016;7(30):47127-33. doi: https://doi.org/10.18632/oncotarget.9478 DOI: https://doi.org/10.18632/oncotarget.9478
Ghosh S, Wadhwa P, Kumar A, et al. Abnormal radiological features in a multiple myeloma patient: A case report and radiological review of myelomas. Dentomaxillofac Radiol. 2011;40(8):513-8. doi: https://doi.org/10.1259/dmfr/74265829 DOI: https://doi.org/10.1259/dmfr/74265829
Palakshappa SG, Wadhwan V, Bansal V, et al. Multiple myeloma presenting as an unhealed extraction socket: Report of a case with brief review of literature. J Oral Maxillofac Pathol. 2018;22(2):284. doi: https://doi.org/10.4103/jomfp.JOMFP_70_16 DOI: https://doi.org/10.4103/jomfp.JOMFP_70_16
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