Excessive Tongue Amyloidosis as the Diagnostic Sign of Multiple Myeloma: a Case Report

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Stylianos Dalampiras1 / 2 / Ioannis Kostopoulos3 / Florentia Stylianou4 / Ioannis Papadiochos1 / Athanasios Poulopoulos2

1School of Dentistry, Department of Oral and Maxillofacial Surgery, Aristotle University, Thessaloniki, Greece
2School of Dentistry, Department of Oral Medicine and Pathology, Aristotle University, Thessaloniki, Greece
3School of Medicine, Department of Histopathology, Aristotle University, Thessaloniki, Greece
4School of Dentistry, student, Aristotle University, Thessaloniki, Greece
5“Evangelismos” General Hospital, School of Dentistry, Athens, Greece

Summary

Background: Deposition of amyloid in oral mucosa may be related to systemic disorders, including immune-related diseases and malignancies.

Clinical Presentation: We describe a case of 76-year-old patient with excessive, painless, multi-nodular tongue enlargement, and petechiae on the vermilion border and perioral skin that appeared 2 months ago. The biopsy detected subepithelial, Congo’s Red positive amyloid depositions. Consequent laboratory investigation and bone marrow biopsy confirmed the diagnosis of multiple myeloma stage 2 (International Prognostic Index – IPI).

Conclusion: Multi-nodular excessive tongue enlargement could be of high significance as initial sign of undiagnosed, underlying systemic disease including severe malignancy like multiple myeloma.

Keywords: Oral Amyloidosis; Macroglossia; Multiple Myeloma

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Citation Information: Balkan Journal of Dental Medicine. Volume 19, Issue 1, Pages 50–52, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2015-0034, July 2015

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