Case report: extranodal T-cell lymphoma (natural killer) mimicking a dentoalveolar abscess

Abstract

T-cell lymphoma (natural killer) is a malignant neoplasm rarely developing extranodal and may mimic odontogenic alterations in the maxillofacial region. A pheoderma 41-year-old woman came to the dental service complaining of painful orofacial symptoms and fever. Clinical examination revealed intra- and extra-oral swelling on the left cheek, marked mobility, and endodontic involvement of the ipsilateral upper molars. The primary diagnostic hypothesis was an acute dentoalveolar abscess, with an initial approach of antibiotic therapy. After 2 weeks, the patients’ pain complaint was persistent, and rapid progression of the facial edema was observed. A computed tomography scan was carried out, which showed an image with soft tissue density, promoting discontinuity of the anterior and lateral walls of the left maxillary sinus. The pathological examination revealed a malignant neoplasm, whose histological type characterizes extranodal T-cell lymphoma (ENKL) in the left maxillary sinus. The proposed treatment for this condition includes radiotherapy and chemotherapy.