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A case report of a patient with amyloidosis presented in which macroglossia and bilateral carpal tunnel syndrome were the initial features and myeloma was the probable underlying cause.
We describe a case in which nodular macroglossia, a very rare type of tongue involvement, was associated with the co-deposition of lambda light chain and beta-2 microglobulin fibrils in the tongue. The combined presence of two different amyloid fibrils did not lead to a more unfavourable clinical outcome. We believe that both these features often remain underdiagnosed and are in fact more frequent than reported. A careful clinical examination of the tongue together with serum immunofixation should be routine in all patients with dialysis-related amyloidosis in order to investigate the prevalence and type of tongue involvement and to rule out other types of amyloidosis. In all cases of suspected mixed amyloidosis, immunohistochemical characterization of fibrils should be carried out by electron microscopy.
OBJECTIVE: To describe the use of a bite guard to avoid continued tongue trauma and edema. DESIGN: Two case reports. INTERVENTIONS: Bite raiser. CONCLUSION: Muscle relaxation and a bite guard were used in a 16 years old male and 22 years old female with traumatic macroglossia, which allowed for rapid resolution of edema and prevented additional trauma to the tongue.
Amyloidosis is a rare disease characterized by the pathological deposit of extracellular proteins in organs or tissues. We report a 78 years old female with a history of euthyroid goiter and carpal syndrome, that presented complaining of weight loss and the sensation of a big and rough tongue. On physical examination, macroglossia and white nodules of 1.5 cm diameter in the mucosa of the mouth, were observed. The pathological examination of these nodules disclosed amyloid infiltration. A bone marrow biopsy showed plasma cell infiltration. The patient was treated with melphalan and prednisone, but she deteriorated progressively and died 14 months after the diagnosis.
Radiotherapy for the nasopharyngeal cancer patient with poor oral care may lead to severe deterioration of the dentition and may require multiple extractions. Although the use of an implant-retained overdenture can successfully restore the function and esthetics of edentulous patients, its use can be complicated by the tissue changes subsequent to head and neck irradiation. The difficulties in implant treatment planning for an edentulous patient with macroglossia and soft tissue changes following radiotherapy are discussed.
We report a case of prominent postoperative macroglossia after posterior fossa surgery in the prone position. The potential risk factors predisposing to its generation, prophylactic measures to avoid it and treatments for its alleviation are reviewed and discussed.
A 63-year-old woman was referred to a department of oral and maxillofacial surgery because of slowly increasing enlargement of the tongue. Histopathologic examination of a biopsy showed the presence of amyloid. Further physical and laboratory studies disclosed the presence of multiple myeloma (Kahler's disease). A few years before, the patient had been operated for metacarpol syndrome of both hands, most likely because of amyloid deposition. The patient underwent a stam cell transplantation. After one year follow-up the patient is still alive. There was no distinct regression of the macroglossia.
It is reported a case of macroglossia with neoplasic-like ulcer in the tongue, in a patient with amyloidosis and hypothyroidism.
While the tongue has been noted to be involved in giant cell arteritis, there are no recorded instances in which the disease has been confined to the tongue. We describe a patient who presented with macroglossia and was found to have a necrotizing vasculitis with giant cells on lingual biopsy. No other evidence for systemic vasculitis was detected. This is the first case report of an isolated vasculitis of the tongue.
The authors report a case of apparently primary amyloidosis in which macroglossia was the clinical presentation, confirmed by lingual biopsy. They take advantage of this case to review the therapeutic possibilities, though stating that from a stomatological standpoint there is virtually nothing available.
A case of extreme macroglossia was observed in a patient with amyloid disease and dysglobulinaemia. A medial diamond-shaped glossectomy was required to reduce the size of the tongue. The details of the surgical and anaesthetic procedure are presented. This type of surgery, greatly appreciated by the patient, can only be undertaken after careful preparation. The reported cases are rare and the indication for surgery is difficult due to the unpredictable nature of the local and general clinical course of the disease.
A case of amyloidosis with macroglossia as a presenting feature is described. The patient was diagnosed to have multiple myeloma at least 1 1/2 year after amyloidosis was diagnosed.
The case of an 8-year-old male diagnosed both clinically and histologically as having lymphangiomatous macroglossia is presented. It is a case that did not require surgical intervention as there were no functional or respiratory deficits. Cases in which there are deficits will require intervention as described.
We report a case of upper airway obstruction as a result of delayed macroglossia in a 17-year-old patient following posterior cranial fossa surgery performed with the patient in a sitting position. Airway obstruction is a life-threatening complication and must be treated promptly. Diverse etiological mechanisms are discussed, along with preventive and therapeutic measures.
Lingual tuberculosis presenting as macroglossia in a 20-year-old woman has been reported. The histopathologic picture was similar to lupus vulgaris and the intradermal tuberculin test showed a strongly positive vesiculobullous reaction after forty-eight hours. No active internal focus of tubercular infection could be detected. The patient responded well to antituberculous chemotherapy. The relative lack of symptoms suggest that the enlargement had been a slow process resulting from the lodging of bacilli in the tongue.
Symmetrical lipomatosis in the oral cavity is extremely rare. Two cases of symmetrical lipomatosis presenting as macroglossia are presented. Glossectomy was performed in order to reduce the size of the tongue and for diagnosis. Because of their multiplicity, non-encapsulation and invasiveness, the lesions were diagnosed histopathologically as symmetrical lipomatosis.
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