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Massive macroglossia, amyloidosis and myeloma.
Postgraduate Medical Journal
|September 1, 1988
Summary
Light-chain myeloma can lead to amyloidosis causing massive macroglossia. Surgical resection of the enlarged tongue effectively restored speech and swallowing functions in a patient.
Area of Science:
- Hematology
- Oncology
- Surgical Pathology
Background:
- Light-chain myeloma is a plasma cell dyscrasia.
- Alkylating agents are commonly used in myeloma treatment.
- Amyloidosis is a potential complication of plasma cell disorders.
Observation:
- A 74-year-old male with light-chain myeloma developed massive macroglossia after 10 years of alkylating agent therapy.
- The enlarged tongue protruded from the mouth, impairing speech and swallowing, and threatening the airway.
- The anterior two-thirds of the tongue were surgically resected as a life-saving measure.
Findings:
- The patient experienced excellent primary healing after the glossectomy.
- Speech intelligibility and swallowing function returned to normal within two weeks post-surgery.
- Surgical correction of massive macroglossia is an effective treatment.
Implications:
- Massive macroglossia, though rare in amyloidosis, is a treatable condition.
- Surgical intervention can significantly improve quality of life in patients with myeloma-related amyloidosis.
- Early recognition and surgical management are crucial for airway protection and functional recovery.