Multiple myeloma presenting as an ill-defined osteolytic lesion of the mandibular condyle: A case report and literature review

Osteolytic lesions of the mandibular condyle can represent a diverse range of differential diagnoses, including malignancies such as metastatic disease, Langerhans cell histiocytosis (LCH), osteosarcoma, chondrosarcoma, and multiple myeloma. This case report details a 40-year-old male with a 3-year history of right temporomandibular joint (TMJ) pain, initially misdiagnosed as temporomandibular disorder. Comprehensive imaging studies, including cone beam computed tomography (CBCT), maxillofacial computed tomography (CT), and brain magnetic resonance imaging (MRI), revealed extensive osteolytic lesions in the mandible, frontal bone, and cervical spine. A CT-guided biopsy confirmed the presence of a plasma cell neoplasm, leading to the diagnosis of multiple myeloma. This case report emphasizes the need for vigilance and comprehensive diagnostic approaches in clinical practice to avoid delays in the identification and treatment of serious underlying conditions such as malignancy. • There is a wide differential diagnosis of osteolytic lesions of the mandibular condyle which includes, but is not limited to, metastatic disease, langerhans cell histiocytosis, osteosarcoma, chondrosarcoma, and multiple myeloma. • The presentation of multiple myeloma within the maxillofacial skeleton is rare. • CT guided biopsy by Interventional Radiologists can be a less invasive way for clinicians to obtain a diagnosis for a lesion involving the maxillofacial skeleton.