The initial symptoms of leukemia include oral manifestations such as gingival hemorrhage and swelling. In patients with these symptoms, attention should be paid to the early diagnosis of acute leukemia. This report describes three cases of acute myelogenous leukemia (AML) with initial manifestations in the oral cavity.
Patient 1: A 32-year-old woman. Ulcer lesions of the oral mucosa were diagnosed as decubital ulcers, and symptoms did not respond to the application of steroid ointment. She also had appetite loss, general malaise, and bloody stools. Blood examination showed a low white-cell count (1,600/μl).
Patient 2: A 52-year-old man. He received anti-inflammatory treatment and had pain at the mandibular third molar region and gingival swelling, but the symptoms did not improve. At the initial visit, pericoronitis of the mandibular third molar with fever and general malaise were observed. Blood examination showed a low white-cell count (2,300/μl) and remarkably increased myeloblasts (20 %) .
Patient 3: A 54-year-old woman. She received medication to treat full-mouth gingival swelling. However, fever and general malaise persisted. Blood examination showed a high white-cell count (47,000/μl).
All three patients were given a diagnosis of AML on bone marrow biopsy.
When the patients present with oral symptoms such as gingival swelling and ulcers accompanied by fever and general malaise, blood examinations should be promptly performed for the differential diagnosis of acute leukemia.
