Intraoral Myeloid Sarcoma as an Early Manifestation of Acute Myeloid Leukemia: Case Report and Literature Review

Abstract

Introduction: When acute myeloid leukemia first manifests, during treatment, or after relapsing, immature myeloid cells make up the extramedullary tumor known as oral myeloid sarcoma (AML). This article's goals are to evaluate instances that have been reported in the literature and to present the clinical characteristics of oral myeloid sarcoma. Case presentation: This case involves a 45-year-old male patient who reported considerable pain and spontaneous bleeding in the vestibular gingiva on the left side, next to the upper premolars. The clinical findings of AML included petechiae in the area of the patient's lower limbs due to thrombocytopenia, which was confirmed in the CBC, in addition to the patient's presenting symptoms of fever, weakness, bodily aches, and diarrhea. A week before to his hospital admission, he started experiencing these symptoms. The initial lab findings showed that there were 231,410 total leukocytes/mm3, 27,000 platelets/mm3, 3.39 million mm/mm3 of red blood cells, and 222,154 circulating blasts, or 96% of total leukocytes. Myelography performed shortly after admission to the hospital showed the presence of cancerous cells, and immunohistochemistry confirmed the diagnosis of AML. Even though PAX-5, CD20, TDT, and CD3 were all negative, myeloperoxidase was positive. Conclusion: We draw the conclusion that oral myeloid sarcoma is uncommon and that it is challenging for both doctors and dentists to diagnose and treat.