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

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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.

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