Significance of Dental Intervention in Onco-Hematological Disorders: A Case Report of Gingival Leukemic Infiltration

Abstract

Introduction

Acute Myeloid Leukemia (AML), a malignant neoplasm characterized by the rapid proliferation of abnormal cells in the bone marrow, often manifests oral signs such as gingival bleeding and purple-colored gum hyperplasia. This clinical case underscores the pivotal role of dentists in diagnosing AML, shedding light on the nuanced presentation of hematological diseases in the oral cavity.

Case Report

A 57-year-old Caucasian female with a history of fibromyalgia and current use of Fluoxetine and Amitriptyline presented with a chief complaint of gum pain and bleeding persisting for 60 days. Clinical examination revealed distinctive purple hemorrhagic gingival hyperplasia, prompting a comprehensive evaluation. Initial investigations, including a full blood count, clotting profile, and HIV serology (suspected Kaposi's sarcoma), returned within normal parameters. Recognizing the potential severity of the oral manifestation, the patient was promptly referred for oncology-hematology assessment. Given the suspicion of an underlying hematologic condition, an incisional biopsy was performed, revealing a diagnosis of Acute Myeloid Leukemia. This diagnosis, unexpected in the absence of abnormal laboratory findings, underscores the imperative role of dental professionals in early detection and referral.

Conclusion

This case serves as a compelling example highlighting the significance of dental professionals in identifying potentially life-threatening oral lesions, even when routine laboratory tests appear normal. The timely and astute recognition of aberrant oral presentations can expedite referral to specialized medical care, significantly influencing patient outcomes. In essence, the presented case reinforces the critical collaboration between dentists and oncology-hematology specialists, emphasizing the need for a comprehensive understanding of oral manifestations of systemic diseases. This interdisciplinary approach contributes not only to the prompt diagnosis of potentially severe conditions like AML but also to the overall well-being of the patient.