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Background/Aim. The depth of invasion of oral cavity carcinoma (OCC) and the nodal involvement define the treatment selection, outcome, and prognosis of the disease. In determining the stage of OCC, the most widely applied methods are computerized tomography (CT) and magnetic resonance imaging (MRI), whose limitations can be overcome to some extent by using intraoral ultrasound (IOUS). The aim of the study was to evaluate the imaging presentation of early-stage OCC, determine the depth of invasion (DOI) and the greatest diameter (GD) of the tumor using the IOUS and CT methods, and compare them with histopathological (HP) findings. Methods. The study was designed as a prospective one, with a time limitation of three months. Eleven patients with clinical early-stage OCC underwent a native CT examination of the head and neck as well as a contrast-enhanced phase, and then IOUS of the lesion was performed. Using both methods, DOI and GD values were measured, and the values were correlated with HP findings. The analysis of the obtained data was per-formed using the statistical package SPSS 22 and Pearson correlation coefficient. Results. A significant correlation (p = 0.001) was established between the DOI values measured by IOUS and CT examination with the measurements obtained by HP processing. On the other hand, by comparing the GD measured on IOUS and CT examination, no correlation was established with the HP report. Conclusion. Measurements of DOI obtained by IOUS significantly correlated with those in the HP report, while overcoming the limitations of the CT method in the evaluation of small-sized tumors and tumors that cannot be shown due to artifacts.

Introduction. Immunoglobulin D (IgD) myeloma is a rare disease, about 2% of all myelomas, even rarer when accompanied with another multiple myeloma in biclonal gammopathy. We presented a case of biclonal gammopathy - associated manifestation of IgD myeloma and light chain disease in a patient who initially had renal failure. Case report. 37-year-old male approximately one month before hospitalization began to feel malaise and fatigue along with decreased urination. Laboratory analysis revealed azotemia. A dialysis catheter was placed and hemodialysis started. The patient was then admitted to our hospital for further tests and during admission, objective examination revealed pronounced paleness with hepatosplenomegaly and hypertension (170/95 mmHg). Laboratory analysis showed erythrocyte sedimentation rate 122 mm/h, expressed anemic syndrome (Hb 71 g/L) and renal failure dialysis rank: creatinine 1,408 μmol/L, urea31.7 mmol/L. There was two M components in serum protein electrophoresis: IgD lambda and free light chain lambda. Proteinuria was nephrotic rank (5.4 g/24 h), whose electrophoresis revealed 2 M components - massive in α 2 fraction of 71%; 7% in the discrete β fraction, beta 2M /serum 110 mg/L, in urine 1.8 mg/L - extremely high; IgL kappa / lambda index 1 : 13 (reference value ratio 2 : 1). The findings pointed to double myeloma disease: IgD myeloma and Bence Jones lambda myeloma. Bone biopsy confirmed IgD myeloma lambda 100% infiltration medulla predominantly plasmablasts. The treatment continued with hemodialysis 3 times per week with chemotherapy protocol bortezomib, doxorubicin, dexamethasone. After 4 cycles of chemotherapy, there was a decrease of IgD, λ - light chains, reduction in proteinuria (1.03 g/24 h), so hemodialysis was reduced to once per week. Six months after treatment initiation the patient underwent autologous bone marrow transplantation. In a 2-year follow-up period double myeloma disease showed complete remission. Conclusion. The presented rare form of double myeloma disease with initial renal insufficiency underscores the importance of careful observation and team-work that can alter the course of this serious disease.