RESUMEN
Extramedullary plasmacytoma (EMP) and solitary bone plasmacytoma (SBP) represent a disease continuum through a multistage process of cell differentiation, survival, proliferation, and dissemination, strictly related to multiple myeloma (MM), the second most common hematological malignancy. Herein, we report two cases of recurrent oral plasmacytoma progressed to MM, in which the first clinical sign of a more widespread disease was limited to the mouth. Based on our experience, we recommend a strict workup for the differential diagnosis between EMP, SBP, and MM for patients with oral plasmacytoma, including radiological exam of the skeleton, magnetic resonance imaging (MRI) of the bone, and positive emission tomography (FDG-PET). MRI and possibly PET can all be used to more sensitively detect EM plasmacytoma sites.
RESUMEN
Osteomyelitis is a relatively frequent bacterial infection of the jaw bones. This report describes a case of mandibular osteomyelitis in a surgical site after enucleation of a follicular cyst and extraction of the associated tooth. This case is unusual because maxillary osteomyelitis generally results from polymicrobial infection. In our patient, however, laboratory analysis identified Pseudomonas aeruginosa as the etiologic agent, an opportunistic pathogen normally found on moist surfaces and vegetation. Notorious for its antibiotic multiresistance, P. aeruginosa is increasingly recognized as a serious problem in hospitalized patients. Isolation of the responsible microbe permitted specific antibiotic treatment with a 10-day course of ciprofloxacin (250 mg/12 h), which fully cleared the infection.
