Gingival enlargement as a periodontal manifestation of acute myeloid leukemia

Abstract

Non-plaque-induced gingival diseases represent a heterogeneous group of systemic conditions that affect the gingival tissues. According to the current classification, they include genetic/developmental disorders, specific infections, inflammatory and immunological diseases and lesions, reactive processes, neoplasms, endocrine, nutritional and metabolic diseases, traumatic lesions and gingival pigmentation (Holmstrup et al. in J Periodontol 89:S28–s45, 2018). They can be challenging for the dentist, as they are often the first symptoms of a serious disease and are often difficult to distinguish from typical diseases of the oral mucosa. An early and correct diagnosis can be crucial for the patient's survival. A 57-year-old woman presented at the Department of Periodontology and Operative Dentistry at Johannes Gutenberg University Mainz. She complained that her gums had been swollen for a week and stated that she had difficulty with oral hygiene as the gums were painful and bled at the slightest touch. She had previously taken amoxicillin 1000 mg (1-1-1) for a week, but this did not lead to any improvement. A blood sample and a biopsy of the gingival enlargement led to the diagnosis of acute myeloid leukemia. The gingival enlargement regressed during the subsequent chemotherapy. After oncological rehabilitation, dental treatment was carried out.