10-year follow-up of adolescent leukemia diagnosed through gingiva: A case report.

Abstract

Background: Systemic diseases often present initial signs through oral manifestations, making early recognition essential for accurate diagnosis and effective treatment planning. Patients with acute lymphoblastic leukemia (ALL) commonly experience gingival issues. This case report discusses the treatment and outcomes of a 12-year-old female patient who presented with gingival swelling and pain and was subsequently diagnosed with ALL.

Methods: The patient underwent chemotherapy and basic periodontal supragingival scaling. Comprehensive clinical assessments, oral photographs, and imaging data were recorded at the initial visit, and at follow-ups 8 years and 10 years later.

Results: A routine blood test and bone marrow aspiration confirmed a diagnosis of B-cell acute lymphoblastic leukemia (B-cell ALL). After 1 year of chemotherapy with rituximab, the patient recovered and was discharged. An 8-year follow-up revealed significant clinical attachment gain and healthy gingival status, and complete recovery was observed at a 10-year follow-up.

Conclusions: Adolescents presenting with swollen and bleeding gums should be evaluated for potential leukemia. Dentists, especially periodontists, should be aware of the oral manifestations of ALL and coordinate with medical professionals to establish a comprehensive, long-term treatment plan. Periodontal health in adolescents with ALL can improve significantly with leukemia remission and appropriate basic periodontal therapy.

Key points: Oral manifestations as early indicators: In adolescents with acute lymphoblastic leukemia (ALL), systemic symptoms may be minimal or absent. Early recognition of oral changes, such as gingival swelling or bleeding, is crucial for timely diagnosis. Long-term periodontal recovery: A 10-year follow-up indicates that periodontal health can improve following leukemia treatment and basic periodontal therapy, although longer follow-up is recommended to assess the stability of recovery.

Plain language summary: It is challenging to recognize systemic diseases early through oral manifestations in adolescents, which is critical for accurate diagnosis. Acute lymphoblastic leukemia (ALL) is a disease of the blood system that manifests itself in the gingiva. This case report describes the early recognition of adolescent ALL through gingival swelling and pain as the initial clinical manifestation and recorded the 10-year follow-up process. After chemotherapy, the patient was cured. In the 8th year, the red, swollen and painful gingiva was relieved, no significant resorption of the alveolar bone was observed, and the periodontal condition was fully recovered two years after basic treatment. This case emphasizes the importance of dentists being vigilant for signs of systemic disease in the oral cavity and the role of long-term periodontal maintenance.