Macroglossia reveals multiple myeloma

Submitted: 31 July 2021
Accepted: 8 November 2021
Published: 25 November 2021
Abstract Views: 1541
PDF: 174
HTML: 667
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

We present an eighty-year old man with a one year history of progressive macroglossia, dysphagia and loss of weight. He had a medical history of arterial hypertension and prostatic hypertrophy which he had under good therapeutic control. The entire tongue was swollen, had hard solidity and was slightly painful upon palpation. A tongue biopsy revealed an amyloid deposition as it coloured bright orange-red on Congo Red staining and lead us subsequently to the diagnosis of amyloidosis; then a bone marrow biopsy confirmed the diagnosis of multiple myeloma. The case was further evaluated by a multidisciplinary team who considered it appropriate to start a lowdose melphalan treatment combined with supportive care. When macroglossia in the tongue is confirmed to be amyloidosis the differential diagnosis should include systemic amyloidosis deposition and multiple myeloma.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Topouzelis N, Iliopoulos C, Kolokitha OE. Macroglossia. Int Dent J 2011;61:63-9. DOI: https://doi.org/10.1111/j.1875-595X.2011.00015.x
da Costa KVT, Ribeiro CMB, de Carvalho Ferreira D, et al. Dysphagia due to macroglossia in a patient with amyloidosis associated with multiple myeloma: a case report. Spec Care Dentist 2018;38:255-8. DOI: https://doi.org/10.1111/scd.12299
Demirkan S, Savk E, Alp A, et al. Macroglossia as a presenting feature of multiple myeloma. J Family Med Prim Care 2017;6:146-7. DOI: https://doi.org/10.4103/2249-4863.214968
Liakou CI, Koh J, Tsimpidakis A, et al. A tongue lesion as a sign of a systemic disease. Case Rep Med 2016;1-3. DOI: https://doi.org/10.1155/2016/6723575
Dawoud BE, Taylor J, Ariyaratnam S, Pemberton MN. Amyloidosis presenting as macroglossia and restricted tongue movement. Dent Update 2016;43:641-7. DOI: https://doi.org/10.12968/denu.2016.43.7.641
Murthy P, Laing, MR. Macroglossia. BMJ 1994;309:1386-7. DOI: https://doi.org/10.1136/bmj.309.6966.1386
García de Guilarte RF, Fronher BB, Urcelay PR, et al. An idiopathic case of macroglossia. J Plast Reconstr Aesthet Surg 2009;62:e41-3. DOI: https://doi.org/10.1016/j.bjps.2007.10.091
Renehan AG, Morton ME. Macroglossia. BMJ 1995;310:329. DOI: https://doi.org/10.1136/bmj.310.6975.329
Benson L, Hemmingsson A, Ericsson A, et al. Magnetic resonance imaging in primary amyloidosis. Acta Radiol 1987;28:13-5. DOI: https://doi.org/10.3109/02841858709177299
Xavier SD, Bussoloti IF, Müller H. Macroglossia secondary to systemic amyloidosis: case report and literature review. Ear Nose Throat J 2005;84:358-61. DOI: https://doi.org/10.1177/014556130508400615
Uesugi A. Multiple myeloma diagnosed from tongue amyloidosis: a case report. J Blood Lymph 2019;9:1. DOI: https://doi.org/10.37421/jbl.2019.9.237
Musat G, Evsei A, Calina D, et al. Rare amyloidoma of the tongue base: a case report and review of the literature. Mol Clin Oncol 2020;12:258-62. DOI: https://doi.org/10.3892/mco.2020.1972
Muchtar E, Buadi FK, Dispenzieri A, Gertz MA. Immunoglobulin light-chain amyloidosis: from basics to new developments in diagnosis, prognosis and therapy. Acta Haematol 2016;135:172-90. DOI: https://doi.org/10.1159/000443200
O’Reilly A, D’Souza A, Lust J, Price D. Localized tongue amyloidosis. Otolaryngol Head Neck Surg 2013;149:240-4. DOI: https://doi.org/10.1177/0194599813490896
Babburi S. Amyloidosis of the tongue - report of A rare case. J Clin diagn Res 2013;7-12:3094-5. DOI: https://doi.org/10.7860/JCDR/2013/7028.3865
Fahrner KS, Black CC, Gosselin BJ. Localized amyloidosis of the tongue: a review. Am J Otolaryngol 2004;25:186-9. DOI: https://doi.org/10.1016/j.amjoto.2004.01.007
Kyle KA, Bayed KD. Amyloidosis: review of 236 cases. Medicine (Baltimore). 1975;54:271-99 . DOI: https://doi.org/10.1097/00005792-197507000-00001
Adamo D, Gasparro R, Marenzi G, et al. Amyloidoma of the tongue: case report, surgical management, and review of the literature. J Oral Maxillofac Surg 2020;78:1572-82. DOI: https://doi.org/10.1016/j.joms.2020.04.022
Babajews A. Occult multiple myeloma associated with amyloid of the tongue. Br J Oral Maxillofac Surg 1985;23:298-303. DOI: https://doi.org/10.1016/0266-4356(85)90048-8
Salisbury PL, Jacoway JR. Oral amyloidosis: a late complication of multiple myeloma. Oral Surg Oral Med Oral Pathol 1983;56:48-50. DOI: https://doi.org/10.1016/0030-4220(83)90054-3
Rajkumar SV. Multiple myeloma: 2016 update on diagnosis, risk-stratification, and management. Am J Hematol 2016;91:719-34. DOI: https://doi.org/10.1002/ajh.24402
Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International myeloma working group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 2014;15:e538-48. DOI: https://doi.org/10.1016/S1470-2045(14)70442-5

How to Cite

Bonvicini, M., Crapanzano, D., Fenu, S., Giordano, M., & Palleschi, L. (2021). Macroglossia reveals multiple myeloma. Geriatric Care, 7(2). https://doi.org/10.4081/gc.2021.10007