An Uncommon Case of Plasma Cell Mucositis of the Tongue in a Young Man

Abstract

Plasma cell mucositis (PCM) is an unusual plasma cell proliferative disorder of the upper aerodigestive tract. It is a rare disease, and its etiology is not yet known with variable clinical features. Symptoms include dysphagia, oral pain, and swelling. We described a case of PCM involving the tongue of a 14-year-old man. In the first place, several diagnostic hypotheses were proposed, most of them discarded for incompatibility with blood and laboratory tests. This disease rarely manifests itself on the tongue, especially in young patients with no comorbidities. The management of PCM is mainly aimed at reducing the symptoms, and in our report, the treatment involved the use of systemic prednisone with an improvement of the quality of life. At 1-year follow-up, there was no recurrence of the disease. Many therapeutic treatments are able to stabilize but not able to induce a complete remission. PCM is considered an uncommon benign disorder with a favorable prognosis and should be considered in the differential diagnosis with other inflammatory or neoplastic conditions.

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“…For precancerous lesions, any clinical modifications were assessed to determine the risk of malignant transformation. Moreover, autoimmune diseases require the management of possible recurrence, pain and oral functional limitation [21,22]. For MRONJ, bone sequestrum, eventual superinfection and pain must be evaluated to control stability or a worsening of the lesions [23][24][25].…”

Unusual oral mucositis

“…The average age of PCM patients is 56 years and the disease seems to affect males slightly more often than females ( 10,11). PCM typically affects the supraglottic larynx, lips, gingiva and palatal mucosa, but it may be seen in the glottic larynx, pharynx, nasal mucosa, buccal mucosa and tongue (11,13). PCM manifests clinically as bright erythema of the mucosa with a cobblestone-like, granular, papillomatous or nodular surface change.…”

“…. Swelling of the attached gingiva or lips may occur ( 10,11). Ulceration is shown to be present in over one fifth of PCM cases (11).…”

“…The condition is typically chronic and may be associated with synchronous or metachronous autoimmune or immune-mediated diseases (10). The patients are most often over 50 , and a slight male predominance has been reported (11). The most common sites of involvement for PCM are the gingiva, lips, palatal and buccal mucosa, and larynx (10,11).…”

“…The patients are most often over 50 , and a slight male predominance has been reported (11). The most common sites of involvement for PCM are the gingiva, lips, palatal and buccal mucosa, and larynx (10,11). PCM typically manifests as intense erythema a of the mucous membranes.…”