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

doi:10.18502/ijhoscr.v19i4.19990

Osias Vieira de Oliveira-Filho Ceará Oncology and Hematology Center, Fortaleza, CE, Brazil
Yuri de Lima Medeiros Department of Stomatology, University of São Paulo, São Paulo, SP, Brazil
Lorena Dos Santos Girão Department of Stomatology, University of São Paulo, São Paulo, SP, Brazil
Igor Campos Guimarães Department of Public Health, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
Henrique Girão Martins Ceará Oncology and Hematology Center, Fortaleza, CE, Brazil
André Costa Teixeira Medical School, Christus University Center, Fortaleza, CE, Brazil
Saygo Tomo Department of Pathology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil

DOI: https://doi.org/10.18502/ijhoscr.v19i4.19990

Keywords: Amyloidosis; Multiple myeloma; Tongue; Ulcers; Macroglossia

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 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. Biopsy is mandatory to confirm the diagnosis, thereby facilitating intervention and management if necessary.