HEAD AND NECK AMYLOIDOSIS AS THE FIRST MANIFESTATION OF MULTIPLE MYELOMA—A CASE REPORT

A 76-year-old man with medical history of anemia was referred for clinical investigation of hoarseness and dysphagia over the last 2 years. Extraoral head and neck examination revealed diffuse hardened skin. Intraoral examination revealed macroglossia with restricted tongue movement and hardening of the lower lip mucosa. Digital panoramic radiograph revealed discreet radiolucent areas affecting the mandible. Incisional biopsy was performed under local anesthesia on the tongue and lower lip. Histopathologic analysis revealed a deposition of hyaline material, mainly surrounding minor salivary glands. Congo red histochemical stain showed apple-green birefringence under polarized light microscopy, confirming the diagnosis of amyloidosis. Laboratory examinations were performed, and the patient was referred to a hematooncologist, who confirmed the diagnosis of multiple myeloma. This report emphasizes the importance of dentists in the diagnoses of systemic conditions, such as primary amyloidosis due to multiple myeloma.