Acute myelomonocytic leukemia presenting with gingival enlargement as the only clinical manifestation

A 34 year old woman reported for evaluation of generalized gingival swelling pain and bleeding. The patient also reported menstrual irregularities. Based on the oral and systemic examinations and hematological investigations, a provisional diagnosis of 'menstrual cycle associated gingivitis' was made. The patient was referred for a gynecologic consultation. At the three-week dental recall, a worsening of gingival overgrowth with a necrotic component was noted. The hematologic investigations revealed markedly elevated leukocyte counts. The clinical and hematological findings led us to a diagnosis of leukemia. This report emphasizes the importance of the dentist as well as the physician (in this case, the gynecologist) in correlating the oral, systemic and hematological findings in the diagnosis and also of regular recall in the management of a case.