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Telagi N, Mujib Ahmed BR. A case of chronic myeloid leukemia presenting as oral ulcers. J Oral Maxillofac Pathol 2021; 25:372. [PMID: 34703143 PMCID: PMC8491358 DOI: 10.4103/0973-029x.325260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 05/18/2021] [Indexed: 11/17/2022] Open
Abstract
The oral signs and symptoms may reflect undetected serious systemic diseases. Depending on the oral manifestation, the dentists and physicians make attention and focusing on specific diagnoses. Here, we represent one such case which was diagnosed after oral signs and symptoms followed by peripheral smear report as chronic myeloid leukemia. Leukemia is among the most prevalent neoplasia, which represents between 30% and 51% of that total. Leukemia is characterized by uncontrolled production of immature white blood cells, causing a series of clinical and oral manifestations, which are important in disease diagnosis. Due to their clinical importance, all such lesions deserve the full attention of dental doctors. Early detection of leukemia is very important because it provides a favorable prognosis.
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Affiliation(s)
- Neethu Telagi
- Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - B R Mujib Ahmed
- Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Mutalik VS, Neppalli V, Dale C, Penner C. Multiple painful ulcerated lesions in a 73-year-old patienti. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:3-7. [PMID: 34518139 DOI: 10.1016/j.oooo.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/11/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Vim S Mutalik
- Assistant Professor, Department of Dental Diagnostic and Surgical Science, Dr. Gerald Niznick College of Dentistry, Winnipeg, Manitoba, Canada.
| | - Vishala Neppalli
- Assistant Professor, Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Catherine Dale
- Assistant Professor, Dental Diagnostic and Surgical Sciences, Dr. Gerald Niznick College of Dentistry, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carla Penner
- Pathologist and Assistant Professor, Department of Pathology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Wang D, He K, Sroussi H, Treister N, Luskin M, Villa A, Woo SB, Shazib MA. Oral myeloid sarcoma as an uncommon manifestation of acute myeloid leukemia: A case series and review of the literature. J Am Dent Assoc 2021; 152:393-400.e8. [PMID: 33926625 DOI: 10.1016/j.adaj.2021.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/13/2020] [Accepted: 01/31/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OVERVIEW Oral myeloid sarcoma (MS) is an extramedullary tumor that can occur in the setting of acute myeloid leukemia, either as the first sign of an underlying disease or later in the course of disease. The authors' aim was to present the clinical features of oral MS and review the literature. CASE DESCRIPTION Case 1 was an 82-year-old woman with an asymptomatic erythematous swelling on the maxillary gingiva and no history of hematologic malignancy. Case 2, a 65-year-old man, and case 3, a 58-year-old woman, each had a history of acute myeloid leukemia and a painful ulcer on the palatal mucosa and an asymptomatic ulcer on the lower lip mucosa, respectively. Case 1 was treated with focal radiation then chemotherapy and achieved complete remission initially, but died of relapse 2 years after diagnosis. Case 2 received radiotherapy and immunotherapy and had a complete response. Case 3 received chemotherapy and achieved remission initially, but relapsed and is undergoing investigational targeted therapies. CONCLUSIONS AND PRACTICAL IMPLICATIONS Oral MS can manifest as gingival or mucosal swelling or ulceration and can indicate onset or relapse of associated hematologic malignancies, which often have a poor prognosis. Because patients with oral findings are likely to seek treatment from their dentists first, oral clinicians should maintain a broad differential diagnosis list when evaluating oral lesions, especially if treatment prescribed for a more common diagnosis fails to resolve the lesion.
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Benites BM, Fonseca FP, Miranda-Silva W, Bruno JS, Tucunduva L, Fregnani ER. Myeloid sarcoma in the tongue. AUTOPSY AND CASE REPORTS 2020; 10:e2020160. [PMID: 33344279 PMCID: PMC7703000 DOI: 10.4322/acr.2020.160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Leukemic cells are rarely present in the oral cavity, and there are very few reports regarding such cases. However, we identified some reports of leukemic cells infiltrating tissues in the oral cavity, including gingival involvement. Recurrent painful oral ulcerations and prominent generalized periodontal destruction are the most common oral features of neutrophil disorders, and they may even be the initial symptoms of the disease. The ulcers may affect any part of the oral mucosa, including the tongue and palate. The objective of this report is to describe and discuss a case of myeloid sarcoma in the oral cavity of a 48-year-old male patient.
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Affiliation(s)
| | - Felipe Paiva Fonseca
- Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Department of Oral Surgery and Pathology. Belo Horizonte, MG, Brazil
| | | | | | - Luciana Tucunduva
- Hospital Sírio-Libanês, Department of Onco-Hematology and Bone Marrow Transplantation. São Paulo, SP, Brazil
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Ishikawa S, Kato Y, Kabasawa T, Yoshioka C, Kitabatake K, Yamakawa M, Ishizawa K, Iino M. A case of myeloid sarcoma of the mandibular gingiva as extramedullary relapse of acute myeloid leukemia. Oral Maxillofac Surg 2020; 24:121-126. [PMID: 31788742 DOI: 10.1007/s10006-019-00812-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/25/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Myeloid sarcoma (MS) is defined as a tumorous mass of myeloblasts or immature myeloid cells involving an extramedullary anatomic site. MS occurs in 3 to 8% of patients with acute myeloid leukemia. The overwhelming majority of MS occurs in the skin, bones, and gastrointestinal tract; intraoral MS (IMS) is extremely rare. METHODS We describe a case of MS of the mandibular gingiva in a patient with acute myeloid leukemia that was in remission. We also present a review of the English and Japanese literature with a special focus on the management and prognosis of intraoral MS. RESULTS The patient was discharged while in remission 8 months after the initial examination. CONCLUSION The prognosis of IMS is extremely poor in general, and a diagnostic delay can prevent adequate therapy by hematologists and oncologists. All dental clinicians must keep the possibility of IMS in mind and carefully examine all patients with AML.
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Affiliation(s)
- Shigeo Ishikawa
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan.
| | - Yuichi Kato
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Takanobu Kabasawa
- Department of Hematology, Department of Pathological Diagnosis, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Chiho Yoshioka
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Kenichiro Kitabatake
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Mitsunori Yamakawa
- Department of Hematology, Department of Pathological Diagnosis, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
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Nunes LFM, Rocha AL, Magalhães GHR, de Melo FHC, Travassos DV, Mesquita RA, Silva TA. Intraoral granulocytic sarcoma as a manifestation of myelofibrosis: A case report and review of the literature. SPECIAL CARE IN DENTISTRY 2018; 38:409-420. [DOI: 10.1111/scd.12325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/09/2018] [Accepted: 07/13/2018] [Indexed: 12/25/2022]
Affiliation(s)
| | - Amanda Leal Rocha
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Gustavo Henrique Romani Magalhães
- Department of Hematology and Oncology; Ambulatory of Chronic Myeloproliferative Diseases; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | | | - Denise Vieira Travassos
- Department of Community and Preventive Dentistry; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
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Gaal A, Chisholm KM, Egbert M. How Rare Is an Oral Presentation of Myeloid Sarcoma in the Infant? J Oral Maxillofac Surg 2018; 76:561-568. [DOI: 10.1016/j.joms.2017.08.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/26/2017] [Accepted: 08/26/2017] [Indexed: 10/18/2022]
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Intraoral Myeloid sarcoma with bilateral involvement: Case report. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Myeloid sarcoma (MS) is a solid malignant tumour associated with infiltration of immature myeloid precursor cells in an extramedullary site. The term MS has replaced the term granulocytic sarcoma and chloroma, which were used in the past. MS in the oral cavity is very uncommon, with less of 40 cases reported until recently. Case Report: We report the first case, the features, and the diagnostic sequence, of intraoral MS with bilateral palatal involvement, which presented as an initial manifestation, and preceded the appearance of acute myeloid leukemia (AML). Diagnostic confirmation of such oral mucosal lesions usually requires biopsy, histopathological examination with additional immunohistochemical investigation. MS can occur during the course of acute or chronic myelogenous leukemia, and myelodysplastic syndromes. In the vast majority of the reported cases, only one site was involved with a single intraoral MS lesion, and the cases predominantly associated with AML. Conclusion: The majority of intraoral MS occurs in patients with known AML, but in some of them, presented as an initial manifestation, and preceded the appearance of the disease. Therefore, clinicians should carefully evaluate all unusual oral lesions of unknown origin.
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Dineshkumar T, Suresh V, Ramya R, Rajkumar K. Primary intraoral granulocytic sarcoma: A rare case presenting as generalized gingival enlargement. J Oral Maxillofac Pathol 2016; 20:523-526. [PMID: 27721621 PMCID: PMC5051304 DOI: 10.4103/0973-029x.190958] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Granulocytic sarcoma (GS) is an extremely rare condition involving infiltration of myeloblasts or immature myeloid cells in an extramedullary site. It is also known as chloroma, myeloid sarcoma or extramedullary myeloid tumor. It usually occurs concomitantly with acute myelogenous leukemia or with the onset of blastic phase of chronic myelogenous leukemia. On rare occasions, it evolves even before the onset of leukemias, and when it precedes leukemias without any overt signs, it is referred to as the primary type. Although GSs can involve any body part, localization in the oral cavity is extremely rare. The recognition of this rare primary entity is important because early aggressive chemotherapy can cause regression of the tumor and improve survival. Here, we report a rare case of GS in a nonleukemic 62-year-old female who presented with generalized gingival enlargement involving both maxilla and mandible.
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Affiliation(s)
- Thayalan Dineshkumar
- Department of Oral Pathology, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India
| | - Vemuri Suresh
- Department of Oral Pathology, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Ramadas Ramya
- Department of Oral Pathology, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India
| | - Krishnan Rajkumar
- Department of Oral Pathology, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India
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