Abstract
We report the rare case of a mandibular fracture in a patient with acute myeloid leukemia(AML). A 69-year-old man was referred to us because of a mandibular fracture. On admission, the white cell count was 14100/μl with 69.5 % blastoid cells, the hemoglobin level was 6.9 g/dl, and the platelet count was 23000/μl. Bone marrow aspiration revealed hypercellular marrow containing many peroxidase-positive blastoid cells(85.4 %). A mandibular fracture with AML was diagnosed, and we initially planned an operation for the mandibular fracture. However, because infection is known to be the most common cause of death in patients with leukemia, antibiotics were administered in accordance with the guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Subsequently, fixation of the mandible and drainage of the intermandibular space were performed, with no evidence of severe infection in the perioperative period. On postoperative day 13, the patient received induction therapy with cytarabine and idarubicin. Although the leukemia responded well to chemotherapy, the patient died of an intracerebral hemorrhage after consolidation therapy.
