Systemic amyloidosis occurs with multiple myeloma at the rate of 5% to 20%, and most cases in the oral and maxillofacial region develop in the tongue and lips. We describe a case of amyloidosis with multiple myeloma in which the tongue grew rapidly, leading to macroglossia.
The patient was a 81-year-old woman. In January 2013, she noticed a mass from the right side to the tip of the tongue and consulted an oral surgeon of a certain hospital. A biopsy of the tongue was performed at the hospital, and the patient was given a diagnosis of a hypertrophic scar. However, her tongue was getting bigger slowly, and she was referred to our hospital in April 2013. Based on diagnostic imaging, a second biopsy was done at the tip of the tongue, and it revealed amyloidosis. Then, a puncture test of bone marrow was performed by an oncolo-hematologist, and multiple myeloma was diagnosed (IgG λ type, ISS III stage). Chemotherapy for the myeloma was started at once, but amyloidosis of tongue and digestive organs progressed very rapidly. The conditions were not able to be controlled, and the patient died 5 months after diagnosis.