Acute myeloid leukaemia (AML) is an acute disease in which B-symptoms such as weakness, fever, and night sweats usually appear early in the case history. However, subtypes of AML can present with specific symptoms, for example in the form of gingival hyperplasia. Sampling (PE) with histological examination is considered the gold standard of diagnosis. We report a case in which a patient with gingival hyperplasia in region 17-13 presented in September 2023. The PE performed revealed the presence of a chloroma (syn. myeloblastoma or granulocytic sarcoma), which is the extramedullary manifestation of AML or an AML-related syndrome. The patient was then referred to the oncology day clinic. After further diagnostics, AML with an NPM1 mutation was detected and the patient was transferred to oncology treatment.
A complete inspection and palpation of the oral cavity is essential for the early detection of (malignant) changes. In addition, systemic diseases often show oral manifestations as an initial or accompanying symptom. Here, the dentist can play a decisive role in quickly establishing the diagnosis. If lesions show no tendency to heal within two weeks despite adequate treatment, the previously made (suspected) diagnosis and the cytological or histological findings must be questioned and repeated if necessary.