Just a Tongue Anomaly or Something More?

A 54-year-old woman with a past history of breast and uterine cancer, appeared at the Emergency Room with a six-month history of fatigue, weight loss (> 12 kg), lower limbs swelling and dysphagia due to progressive tongue enlargement. ENT examination demonstrated macroglossia (Fig. 1-A), that was confirmed by computed tomography (CT) scan (Fig. 1-B). Laboratory tests complemented with image findings showed the presence of a restrictive cardiomyopathy and a nephrotic syndrome. The abdominal fat biopsy with immunofixation electrophoresis was positive for light-chain amyloidosis. The patient began chemotherapy treatment with bortezomib, dexamethasone and cyclophosphamide, completing four cycles of treatment with frank tongue reduction. The patient died 5 months after the diagnosis.[...]