Which oral finding may develop in a patient with multiple myeloma secondary to systemic amyloidosis?

Correct answer: B. Macroglossia

• A. Enamel hypoplasia arises from insults during tooth development, long before myeloma would occur.
• B. Correct. In multiple myeloma the excess monoclonal light chains can deposit in tissues as AL AMYLOID. Deposition in the tongue produces MACROGLOSSIA — a firm, enlarged tongue, often with lateral scalloping from tooth indentations, sometimes with nodules or haemorrhagic bullae. Amyloid macroglossia is one of the classic oral clues to systemic amyloidosis, alongside the punched-out radiolucencies of the skull and jaws seen in myeloma itself.
• C. Cleft palate is a developmental defect present from birth.
• D. Parotid aplasia is a rare congenital anomaly unrelated to myeloma.