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Multiple myeloma initially manifesting as a solitary deep ulcer on the tongue: a case study and literature review

  • Clinical Report
  • Published:
European Journal of Dermatology

Abstract

Background

Multiple myeloma (MM) is a malignant disease associated with clonal plasma cell proliferative disorder, characterized by extensive infiltration of clonal plasma cells in the bone marrow, for which a proportion of patients suffer poor outcome and exhibit no obvious symptoms in the early stages. Amyloidosis is a rare condition caused by MM. Immunoglobulin light chain amyloidosis (AL) is caused by the secretion of specific toxic light chain proteins from proliferating clonal B cells or plasma cells. These light chain proteins accumulate in human tissues and cause organ dysfunction and failure. Oral manifestations of amyloidosis include macroglossia, prominent lingual margins, coloured papules, purpura, and nodular protrusions.

Objectives

To describe and summarize the oral manifestations associated with AL amyloidosis in order to achieve an accurate clinical diagnosis.

Materials & Methods

We present a case of AL amyloidosis associated with multiple myeloma and review the literature on other related cases identified from the inception of Medline.

Results

A female patient visited our clinic with a deep tongue ulcer. After oral biopsy and tissue staining, combined with the examination results from the Department of Haematology, the patient was diagnosed with oral AL amyloidosis related to multiple myeloma.

Conclusion

This is the first case study of AL amyloidosis secondary to latent MM presenting as a solitary tongue ulcer. Chronic oral refractory ulcers may be associated with systemic diseases and should be considered in future clinical practice.

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Acknowledgements

we would like to thank all staff at the Department of Oral Pathology in West China Hospital of Stomatology of Sichuan University for their assistance in pathological investigation.

Funding

Formatting of funding sources this work was supported by National Natural Science Foundation of China (82272899, 81902782, 81730030, 82203180), Research Funding from West China School/Hospital of Stomatology Sichuan University (No.RCDWJS2022-16), the 14thspecial grant from China Postdoctoral Science Foundation (2021T140484), Postdoctoral Research Funding of Sichuan University (2022SCU12132), Research and Exploration Program of West China Hospital of Stomatology of Sichuan University(No. RD-02-202204), Key Research Program of Sichuan Provincial Science and Technology Agency (2023YFS0127) and the CAMS Innovation Fund for Medical Sciences(CIFMS,2019-I2M-5-004).

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Authors and Affiliations

  1. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, China

    You Zhang, Yuqi Wu, Xiaodong Feng, Xiaobo Luo & Qianming Chen

  2. State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China

    Lihong Yao

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  1. You Zhang
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  2. Yuqi Wu
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  3. Lihong Yao
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  4. Xiaodong Feng
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  5. Xiaobo Luo
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Corresponding authors

Correspondence to Xiaobo Luo or Qianming Chen.

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Cite this article

Zhang, Y., Wu, Y., Yao, L. et al. Multiple myeloma initially manifesting as a solitary deep ulcer on the tongue: a case study and literature review. Eur J Dermatol 33, 618–623 (2023). https://doi.org/10.1684/ejd.2023.4628

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