Ulcerated Tongue Borders as a Sign of Amyloidosis in a Patient with Multiple Myeloma
-
Osias Vieira de Oliveira-Filho
,
Yuri de Lima Medeiros
,
Lorena Dos Santos Girão
,
Igor Campos Guimarães
,
Henrique Girão Martins
,
André Costa Teixeira
,
Saygo Tomo
Abstract
Amyloidosis is characterized by extracellular deposition of amyloid material in various tissues and organs. Deposition of amyloid in the tongue is rare but often occurs in multiple myeloma. Here we present the case of a 44-year-old woman under treatment for multiple myeloma who complained of lateral tongue pain. Intraoral examination revealed an ill-defined, firm, whitish swelling with an ulcerated surface on the bilateral borders of the tongue. Histopathological analysis revealed a lympho-mononuclear infiltration in the lamina propria with the presence of acellular and amorphous material positive for Congo red staining. Further examination revealed amyloidosis in a cervical mass associated with neural compression. Thorough examination of the oral cavity in patients with multiple myeloma is critical for early detection of amyloidosis. A biopsy is mandatory to confirm the diagnosis, thereby facilitating intervention and management if necessary.
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9. Tao Y, Qiu X, Ye F, et al. Amyloidosis of the tongue: a rare case report. Braz J Otorhinolaryngol. 2023; 89(4): 101286.
10. Kaushik R, Pushpanshu K, Punyani SR. Orofacial amyloidosis—unusual presentation of a rare condition: A case report. Spec Care Dentist. 2016; 36(2): 104-107.
11. Bezerra HKF, de França TRT, Prado JD, et al. Oral localized amyloidosis. Head Neck Pathol. 2022; 16(3): 818-822.
12. Penner CR, Műller S. Head and neck amyloidosis: a clinicopathologic study of 15 cases. Oral Oncol. 2006; 42(4): 421-9.
13. Kanemoto H, Obata K, Kadoya K, et al. A Rare Case of Multiple Myeloma Identified Following the Diagnosis of Amyloidosis of the Tongue. Case Rep Dent. 2024; 2024: 2024:8836103.
14. Gómez-Piña JJ, Quiroz DM, Sierra-Hernández A, et al. Lengua gigante condicionante de disfagia en paciente con amiloidosis de cadenas ligeras. Rev Med Inst Mex Seguro Soc. 2023; 61(6): 863-867.
15. Mawardi HH, Akeel SK, Ali SA, et al. A 65-Year-Old Woman with an Enlarged Tongue Due to Amyloidosis. Am J Med Case Rep. 2022; 23: e936192.
16. da Costa KVT, Ribeiro CMB, Ferreira DC, et al. Dysphagia due to macroglossia in a patient with amyloidosis associated with multiple myeloma: A case report. Spec Care Dentist. 2018; 38(4): 255-258.
17. Tavares TS, da Costa AAS, Araújo ALD, et al. Oral manifestations of amyloidosis and the diagnostic applicability of oral tissue biopsy. J Oral Pathol Med. 2024; 53(1): 61-69.
18. Razmara F, Derakhshan S, Mahdavi N, et al. Solitary amyloid tumor of the palate: A case report and literature review. Rare Tumors. 2023; 15: 20363613231166540.
2. Pontes FS, Ferreira GB, Fonseca FP, et al. Oral amyloidosis: an update. Med Oral Patol Oral Cir Bucal. 2023;28(4): e341-e346.
3. Matsuo FS, de Paulo LFB, Servato JPS, et al. Involvement of oral tissues by AL amyloidosis: a literature review and report of eight new cases. Clin Oral Investig. 2016; 20(8): 1913-1920.
4. Dawoud BE, Taylor J, Ariyaratnam S, et al. Amyloidosis presenting as macroglossia and restricted tongue movement. Dent Update. 2016; 43(7): 641–2, 645-7.
5. Dissanayaka DWVN, Bandara HMMR, Sabesan T, et al. Oral manifestations of systemic amyloidosis, an aid to diagnosis of multiple myeloma - report of two cases. Braz J Otorhinolaryngol. 2022; 88(1): 146-149.
6. Leiba M, Jarjoura S, Abboud W, et al. Role of oral examination in newly diagnosed multiple myeloma patients: A safe and simple way to detect light chain amyloidosis. Oral Dis. 2018; 24(7): 1343-1348.
7. Chebil RB, Nour M, Eya M, et al. Oral manifestations of undiscovered systemic amyloidosis: a series of seven cases. Pan Afr Med J.2024; 49:89.
8. Suriyakala M, Sreela LSN, Mathew P, et al. Macroglossia Associated With Primary Systemic Amyloidosis-Case Report With Unusual Clinical Presentation. J Ayub Med Coll Abbottabad. 2022; 34(1): 197-199.
9. Tao Y, Qiu X, Ye F, et al. Amyloidosis of the tongue: a rare case report. Braz J Otorhinolaryngol. 2023; 89(4): 101286.
10. Kaushik R, Pushpanshu K, Punyani SR. Orofacial amyloidosis—unusual presentation of a rare condition: A case report. Spec Care Dentist. 2016; 36(2): 104-107.
11. Bezerra HKF, de França TRT, Prado JD, et al. Oral localized amyloidosis. Head Neck Pathol. 2022; 16(3): 818-822.
12. Penner CR, Műller S. Head and neck amyloidosis: a clinicopathologic study of 15 cases. Oral Oncol. 2006; 42(4): 421-9.
13. Kanemoto H, Obata K, Kadoya K, et al. A Rare Case of Multiple Myeloma Identified Following the Diagnosis of Amyloidosis of the Tongue. Case Rep Dent. 2024; 2024: 2024:8836103.
14. Gómez-Piña JJ, Quiroz DM, Sierra-Hernández A, et al. Lengua gigante condicionante de disfagia en paciente con amiloidosis de cadenas ligeras. Rev Med Inst Mex Seguro Soc. 2023; 61(6): 863-867.
15. Mawardi HH, Akeel SK, Ali SA, et al. A 65-Year-Old Woman with an Enlarged Tongue Due to Amyloidosis. Am J Med Case Rep. 2022; 23: e936192.
16. da Costa KVT, Ribeiro CMB, Ferreira DC, et al. Dysphagia due to macroglossia in a patient with amyloidosis associated with multiple myeloma: A case report. Spec Care Dentist. 2018; 38(4): 255-258.
17. Tavares TS, da Costa AAS, Araújo ALD, et al. Oral manifestations of amyloidosis and the diagnostic applicability of oral tissue biopsy. J Oral Pathol Med. 2024; 53(1): 61-69.
18. Razmara F, Derakhshan S, Mahdavi N, et al. Solitary amyloid tumor of the palate: A case report and literature review. Rare Tumors. 2023; 15: 20363613231166540.
| Files | ||
| Issue | Vol 19 No 4 (2025) | |
| Section | Case Report(s) | |
| Keywords | ||
| Amyloidosis; Multiple myeloma; Tongue; Ulcers; Macroglossia | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Vieira de Oliveira-Filho O, de Lima Medeiros Y, Dos Santos Girão L, Campos Guimarães I, Girão Martins H, Costa Teixeira A, Tomo S. Ulcerated Tongue Borders as a Sign of Amyloidosis in a Patient with Multiple Myeloma. Int J Hematol Oncol Stem Cell Res. 2025;19(4):429-433.
