Multiple Myeloma Presenting Symptoms in the Oral and Maxillofacial Region

Four cases of multiple myeloma presenting symptoms in the oral and maxillofacial region are reported. The main complaints in 2 patients were macroglossia and dysphagia. We doubted these cases were amyloidosis, but examinations performed for possible amyloidosis led us to a diagnosis of multiple myeloma. The other 2 patients presented signs in the mandible. One of them had a mass-type lesion in the gingiva which upon X-ray revealed an osteolytic lesion in the mandible and multiple "punched-out" osteolytic lesions in the cranial bones. The other showed only a diffuse non-homogeneous radiolucent lesion and dental ankylosis. Medical history and biochemical and hematologic findings would be helpful in diagnosing multiple myeloma. Here, we report our summarization of these 4 cases

Polymorphous Low-Grade Adenocarcinoma Arising at the Retromolar Region: A Rare Case of High-Grade Malignancy

Polymorphous low-grade adenocarcinoma (PLGA) is an entity under the subclassification of adenocarcinoma from salivary glands. We report here a rare case of PLGA with suspected metastases to a regional lymph node and the liver, confirmed by magnetic resonance imaging and computed tomography. An 88-year-old Japanese woman complaining of pain in the left mandible, specifically in the gingiva upon swallowing, was referred to our clinical department in July 2003. The pain in the left mandibular gingiva had been noted 10 months before the first medical examination. Oral examination revealed a 38 × 30 mm mass forming from the left retromolar region to the glossopalatal arch with ulcer. An incisional biopsy of the mass revealed PLGA. Histopathologically, tumor cells presenting mild atypia showed tubular and cribriform structures. Immunohistochemically, the Ki-67 labeling index showed 31% suggesting a potential high-grade malignancy of tumor cells

A 6-Year Controlled Gastric Adenocarcinoma Metastasized to the Lung, Cervical Spine and Mandible in a Japanese Male: A Patient Report

Gastric adenocarcinoma metastasized to the lung, cervical vertebrae and mandible 6 years after gastrectomy in a 70-year-old man. When the man visited our clinic, he complained of pain in the left mandible with paralysis in the left lower lip and diffuse swelling with a fluctuation inside the left ramus of the mandible. Medium contrast computed tomography (CT) presented bone loss that looked like a wormhole at the left angle of the mandible. Magnetic resonance imaging (MRI) revealed abscess or osteomyelitis at the site. He showed no response despite treatment with antibiotics, and we suspected a neoplastic lesion. With a mandibular ramus specimen obtained by biopsy and examined histopathologically, adenocarcinoma of the salivary gland was strongly suspected. MRI presented a neoplastic lesion in his cervical vertebrae, and by biopsy he was diagnosed with adenocarcinoma. Thereafter, chest CT presented multiple pulmonary metastases. Considering the patient’s history of gastrectomy due to gastric adenocarcinoma, the stomach, cervical vertebrae or mandible were examined pathologically and immunohistochemically by biopsy: all specimens showed a moderately differentiated type of tubular adenocarcinoma, and the results for cytokeratin-related tumor markers were the same. We finally diagnosed him as having metastases from gastric adenocarcinoma to the lung, cervical vertebrae and mandible. Because the metastases had spread to multiple organs, the mandibular lesion was not treated, and terminal care in another facility was unavoidably selected. In making a differential diagnosis of multiple metastases, pathological and immunohistochemical examinations of metastatic lesions by biopsy were very useful based on the diagnostic imagings by CT and MRI

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements