Intra‐oral noma‐like lesion associated with acute myeloid leukaemia: a case report

Abstract

Listen

Translate article

AbstractAcute myeloid leukaemia is a malignancy of the white blood cells that can develop in both children and adults with rapid development and possible intra‐oral manifestations.This report describes a case involving a 50‐year‐old patient who was referred to the Emergency Department of a University Dental Hospital complaining of severe intra‐oral ulceration, spontaneous intra‐oral bleeding and generalised fatigue and malaise. Examination revealed the existence of an erythematous intra‐oral necrotising, noma‐like, ulceration in the posterior area of the right buccal mucosa. The patient was diagnosed with acute myeloid leukaemia.Acute myeloid leukaemia develops rapidly and the initial symptoms may be non‐specific. Patients may demonstrate intra‐oral manifestations; most common symptoms include spontaneous gingival bleeding, gingival enlargement and acute ulceration. Ulceration with necrotising (noma‐like) characteristics is a rare oral manifestation of acute myeloid leukaemia, the cause of which is yet unknown. Fewer than 10 cases have been reported in the international literature.Intra‐oral pathology can be an early indicator of significant medical pathology. A dental practitioner is likely to be the first point of contact for patients with acute myeloid leukaemia due to the unusual or painful nature of the intra‐oral pathology; identification of suspicious signs and symptoms can lead to early detection and treatment.Clinical relevance Leukaemia may present initially to dental practitioners because of a high incidence of early intra‐oral signs and symptoms. A high index of suspicion for underlying systemic disease will lead to prompt onward referral for specialist investigations.Oral presentations may include spontaneous gingival bleeding and gingival enlargement. A rare oral presentation of acute myeloid leukaemia is deep and severe oral ulceration presenting as a noma‐like lesion, which we present here.