Unusual case of oral chronic lymphocytic leukemia presenting as recurrent epistaxis and asymptomatic intraoral swelling

Rev Stomatol Chir Maxillofac. 2012 Dec;113(6):455-7. doi: 10.1016/j.stomax.2012.10.001. Epub 2012 Nov 13.

Abstract

Introduction: Usually, oral manifestations of chronic lymphocytic leukemia CLL are related to an advanced stage of a diagnosed disease, and rarely may lead to diagnosis. CLL can also present as bleeding, rarely isolated. We report a rare case of CLL the first symptoms of which were recurrent epistaxis and asymptomatic intraoral swelling.

Case presentation: A 74-year-old woman consulted for recurrent epistaxis. She presented with a small asymptomatic swelling in the left superior vestibule. Computed tomography revealed a tissular-like mass without invasion of surrounding tissues. The hemogram revealed thrombocytopenia and leukocytosis with 51% of lymphocytes. The immuno-histochemical analysis of the lesion and of the bone marrow allowed diagnosing stage IV CLL.

Discussion: CLL may present as unusual symptoms. It should be suspected in elderly patients presenting with atypical clinical signs such as oral swelling or signs of bone marrow involvement.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • Diagnosis, Differential
  • Epistaxis / diagnosis*
  • Female
  • Follow-Up Studies
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis*
  • Leukocytosis / diagnosis
  • Mouth Diseases / diagnosis*
  • Mouth Mucosa / pathology
  • Mouth Neoplasms / diagnosis*
  • Neoplasm Staging
  • Recurrence
  • Thrombocytopenia / diagnosis
  • Tomography, X-Ray Computed