Boffano Paolo, Viterbo Stefano, Barreca Antonella, Berrone Sid
Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
J Craniofac Surg. 2011 Jul;22(4):1312-5. doi: 10.1097/SCS.0b013e31821c6cbe.
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.
作者报告了一例以病理性下颌骨骨折为多发性骨髓瘤首发体征的患者的治疗情况。该患者接受了对病理性骨折和溶骨性病变累及的下颌骨区域的手术切除。然后，他被给予沙利度胺、美法仑和泼尼松联合进行全身治疗。患者对治疗耐受性良好，目前正在门诊随访。与孤立性多发性骨髓瘤病变相关的下颌骨病理性骨折的治疗应包括对病变累及的下颌骨进行节段性切除。可以立即进行或延迟进行适当的重建。无论如何，始终应牢记尽早开始全身治疗的重要性。
