Unusual presentation of oral amyloidosis

Abstract

Amyloidosis is a rare disease of difficult diagnosis that occurs due accumulation of amyloid substance localized or systemic. The oral cavity is an unusual site and can be related to both localized and systemic forms and for that reason a full investigation is necessary to determine the extent of the disease. This study reports a case of a 58-year-old melanoderm male patient referred to the Department of Oral and Maxillofacial Surgery with white plaques on the tongue and multiple nodules in the region of the buccal mucosa and labial commissure, with 6 months of evolution and painful symptoms. An incisional biopsy was performed on both sites and histological examination indicated the presence of eosinophilic amorphous material within the connective tissue, positive for crystal violet staining, consistent with amyloidosis. At the present time, there is no consensus on the management of local amyloidosis. Surgical treatment of localized forms is indicated in some cases to reduce the functional prejudice. Moreover, follow-up is mandatory, both to manage recurrences and to monitor the possible evolution of the disease to the systemic form.

Keywords: Amyloidosis; amyloid nodules; multiple myeloma.

Figure 1

Clinical aspect of the white plaque on the lateral border of the tongue and nodules on the commissure

Figure 2

Epithelial hyperplasia and the presence of homogeneous, eosinophilic and amorphous material in corion consistent with amyloid. Positive crystal violet staining: Amyloid exhibit metachromasia