Mental nerve neuropathy: a symptom of Waldenström's macroglobulinemia.

The uncontrolled production of immunoglobulins in Waldenström's macroglobulinemia, a neoplastic plasma cell disorder, results in hyperviscosity of blood and multisystem organ derangement. Previously reported orofacial manifestations have been limited to osteolytic lesions of the jaw, ulcerations of the mucosa and tongue, gingival bleeding, and enlargement of salivary and lacrimal glands. Mental nerve anesthesia resulting from IgM deposition on the myelin sheath is a previously unreported early warning sign of advancing disease. Its occurrence heralds the need for aggressive medical management.