ORAL AMYLOIDOSIS AS PRIMARY MANIFESTATION OF MULTIPLE MYELOMA IN ELDERLY WOMEN

Multiple myeloma (MM) is an uncommon plasma cell malignancy with a slight male predilection. Up to 15% of patients with MM present an abnormal deposition of amyloid tissue. In the oral cavity, this deposition develops as macroglossia. A 69-year-old woman presented with a 9-month history of painless tongue enlargement. Microscopic analysis showed amorphous and eosinophilic deposits in the dermis compatible with amyloid. Congo red stain was positive. Myelogram verified 29% of plasma cells, and monoclonal isolated lambda protein was found in the urine and serum. An 87-year-old woman presented with a 6-month history of tongue and cervical lymph node enlargement. Amorphous hyaline material deposits were microscopically observed in the tongue and lymph node biopsies. Myelogram verified 4% of plasma cells. Due to its unfavorable prognosis, an early diagnosis of MM is extremely important. Dental surgeons have a key role in identifying an oral manifestation of onco-hematological diseases and must be aware of their clinical characteristics.