Acute myeloid leukaemia diagnosed by intra-oral myeloid sarcoma. A case report.
Myeloid sarcoma (MS) is a rare extramedullary malignant tumor composed of immature myeloid cells. It is strongly associated with a well known or covert acute myeloid leukaemia, chronic myeloproliferative diseases or myelodysplastic syndromes. Intraoral MS scarcely occurs. An unusual case of acute myeloid leukaemia, which was diagnosed by mandibular MS that was developed in the alveolar socket after a dental extraction, is reported. The histological examination (including immunohistochemical analysis) of a subsequent biopsy showed infiltration of the oral mucosa by neoplastic cells. This lesion was therefore classified as acute myeloid leukaemia. The patient was referred to oncologists that confirmed the initial diagnosis. The patient underwent chemotherapy and the mandibular tumor disappeared. Forty days later, a relapse of the disease, which appeared as a great-ulcerated lesion, was developed in the hard palate. Thirty days after the second chemotherapy had finished, a new intraoral tumor was developed in the vestibular maxillary gingiva. Review of the literature shows no report of intraoral relapse and particularly multiple relapse of a MS that involves the oral cavity. Even though MS is encountered infrequently in the oral cavity, it should be considered in the differential diagnosis of conditions (especially tumors) with a similar clinical appearance.
Papamanthos
Mattheos K
MK
Department of Dentistry, General Hospital of Volos, Volos, Greece. manpapaman@hotmail.com
Kolokotronis
Alexandros E
AE
Skulakis
Haralampos E
HE
Fericean
Angela-Monika A
AM
Zorba
Matina T
MT
Matiakis
Apostolos T
AT
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D005047:Etoposide / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000188:drug therapy; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000188:drug therapy; D023981:Sarcoma, Myeloid / Q000175:diagnosis* / Q000188:drug therapy
D000970:Antineoplastic Agents; D005047:Etoposide