Oral AA amyloidosis with granulomatous cheilitis: a case report and literature review.

We report a rare case of oral AA amyloidosis coexisting with granulomatous cheilitis. A 48-year-old woman presented with extensive, rubbery, nodular masses on the buccal mucosa accompanied by fluctuating granulomatous cheilitis. Laboratory findings showed elevated levels of C-reactive protein (CRP), rheumatoid factor (RF), serum free kappa light chain ( κ ), serum free lambda light chain ( λ ), and serum amyloid A (SAA). In the pathological examination, Congo-red staining showed a characteristic apple-green birefringence under polarized light. The final diagnosis is AA amyloidosis with granulomatous cheilitis. After a period of treatment with prednisone acetate tablets, the patient's clinical symptoms improved. This case highlights the importance of oral manifestations in the early diagnosis of systemic amyloidosis and suggests that clinicians should be vigilant about the potential of systemic diseases when facing similar oral symptoms. Meanwhile, we reviewed 31 cases of oral amyloidosis identified in 22 published reports and discussed the pathophysiological mechanism of amyloidosis, providing ideas for subsequent treatment. KEY POINTS: ∙ We report a rare case of oral AA amyloidosis coexisting with granulomatous cheilitis. ∙ We explore the potential association and immunological mechanisms between these two conditions.