Gingival Enlargement Can Constitute the Only Diagnostic Sign of Leukemia: Report of an Unusual Case

Abstract

Gingival hyperplasia may arise due to microbial-related local irritation, mouth breathing, drug administration, genetic disorders, leukemia, Wegener granulomatosis, Crohn’s disease, and sarcoidosis. The background may be inflammatory, fibrotic, or combined. The aim of this study was to present the diagnostic procedure for a case of gingival enlargement, which was the only sign of a severe systemic disease in a young male adult. The patient was referred, complaining of persistent gingival bleeding in the posterior area of the maxilla, bilaterally. Clinically, a diffuse gingival enlargement was noticed without regional lymphadenopathy. The histopathological examination revealed abundant neoplastic cells of hemopoietic origin with strong and diffuse positivity for CD45 and CD68, and in addition, scattered neoplastic cells exhibited mild to moderate positivity for c-kit (CD117), indicating the diagnosis of acute myeloid leukemia, which diffusely infiltrated the lamina propria of the gingiva. The numerous conditions leading to gingival enlargement other than gingivitis or periodontitis are a diagnostic challenge in clinical practices. From this point of view, the role of the dentist is crucial when commencing the diagnosis of severe systemic diseases like leukemia.