Introduction: Multiple myeloma (MM) is a hematologic neoplasm that affects bone metabolism and causes osteolytic lesions. Cone beam computed tomography (CBCT) demonstrates excellent performance in detecting and characterizing these lesions when involving the skull. It is a low-cost examination that emits low doses of radiation compared to other tomographic modalities. This study aimed to present the various patterns of maxillary bone destruction observed in CBCT images of 27 MM patients, acquired at different time points after diagnosis, and to establish correlations with clinical data.
Methods: For the evaluation and characterization of lesions, multiplanar reconstructions were chosen, with the application of enhancement filters. Four distinct patterns of bone destruction were detected: diffuse, multilocular, unilocular, and perforated.
Results: The study sample consisted of 48% female and 52% male patients, with a mean age of 56.5 years. The diffuse pattern predominated, affecting both maxillae. Multilocular and unilocular patterns were identified in 50% and 22.2% of cases, respectively, with the condyle being the most affected region. Perforated lesions were not observed in any case. Clinical data revealed that 37% of cases met the IIIA criteria and 37% met the IIIB Durie Salmon criteria. Bone lesions in more than 3 locations of the body or the presence of fractures were identified in 50% of cases. Osteonecrosis in the maxillae was reported in only 1 case.
Conclusions: No significant relationship was observed between clinical characteristics and the identified tomographic patterns of bone destruction. The absence of perforated lesions may be attributed to three-dimensional visualization, revealing a diffuse pattern extending from cortical to trabecular bone structures.
