Abstract
A 10-year-old female was referred for investigation of a 4-month history of a swelling in the anterior mandible producing facial asymmetry, accompanied by joint pain, vomiting, and weight loss. Intra-oral examination revealed nonpainful submucosal swelling with telangiectasia areas on the overlying mucosa and teeth mobility. Panoramic radiograph showed a poorly defined radiolucent image in a “floating teeth pattern.” Computed tomography revealed buccal and lingual cortical bone destruction without root resorption. Incisional biopsy was performed and histopathologic analysis revealed a diffuse proliferation of “small round blue cells” displaying angiocentricity. The tumor cells showed positivity for LCA, CD79 a, CD99, TdT, FLI-1, and Ki-67(90%). The patient was referred to an oncology center with a suggestive diagnosis of B-cell lymphoblastic lymphoma. Bone marrow aspiration demonstrated 50% of lymphoblast infiltration, leading to the final diagnosis of extramedullary B-cell acute lymphoblastic leukemia/lymphoma infiltrating the mandible. The patient is undergoing oncology treatment, and disease is currently controlled.
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