Acute Myeloid Leukaemia Diagnosed by Intra-Oral Myeloid Sarcoma. A Case Report

• Published in: Head & neck pathology (Totowa, N.J.) Vol. 4; no. 2; pp. 132 - 135
• Main Authors: Papamanthos, Mattheos K., Kolokotronis, Alexandros E., Skulakis, Haralampos E., Fericean, Angela-Monika A., Zorba, Matina T., Matiakis, Apostolos T.
• Format: Journal Article
• Language: English
• Published: New York Humana Press Inc 01.06.2010
• Subjects: Aged; Antineoplastic Agents - therapeutic use; Biopsy; Case Report; Dentistry; Diagnosis, Differential; Etoposide - therapeutic use; Fatal Outcome; Female; Humans; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - drug therapy; Medicine; Medicine & Public Health; Mouth Mucosa - pathology; Mouth Neoplasms; Neoplasms, Multiple Primary - diagnosis; Neoplasms, Multiple Primary - drug therapy; Oral and Maxillofacial Surgery; Otorhinolaryngology; Pathology; Sarcoma, Myeloid - diagnosis; Sarcoma, Myeloid - drug therapy; Acute myeloid leukaemia; Chloroma; Myeloid sarcoma; Oral tumors; Granulocytic sarcoma
• ISSN: 1936-055X; 1936-0568
• DOI: 10.1007/s12105-010-0163-9

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.