Oral medicine case book 41--Acanthosis Nigricans.

The Oral Medicine Team at Western Cape have taken a well-earned rest this month, and we are delighted to include a Case Book prepared by a team from Wits. It is likely that the source of the contributions will be varied from time to time. We look forward to the next Case Book, which will again come from Western Cape.

Post-chemotherapeutic resolution of acute myeloid leukaemia-induced gingival enlargement: a case report.

INTRODUCTION: Leukaemia is a neoplastic dsorder characterized by an excessive proliferation of immature white blood cells and their precursors. Patients with this potentially fatal condition may often first present with gingival enlargement. Early diagnosis of the underlying condition and prompt referral for appropriate therapy, may be life-saving. CASE REPORT: A 27-year-old female was referred to the Department of Oral Medicine and Periodontology complaining of a generalised gingival enlargement that was aesthetically displeasing to her. She insisted on immediate surgical removal of the enlarged gingival tissue but, on counseling, agreed to have prior diagnostic tests performed. A full blood count suggested the presence of an underlying acute myeloid leukaemia. The patient was consequently referred to the Oncology Department for further investigation and management. The diagnosis was confirmed and the subsequent chemotherapeutic intervention was strikingly successful, leading to the complete resolution of the gingival enlargement. CONCLUSION: This paper emphasises the importance of a full diagnostic evaluation of all cases of gingival enlargement and immediate referral should a life-threatening condition be identified, such as, in the present case, acute myeloid leukaemia.