口腔外科小手術後の止血困難により診断にいたった急性前骨髄球性白血病の1例

概要

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In the oral field, it is rare for acute promyelocytic leukemia (APL) to be reported. A patient, who presented a chief complaint of bleeding tendency after a minor oral surgical procedure, was referred to us. The diagnosis of APL was reached and herein the case is reported. A 52-year-old male developed continuous gingival bleeding from the operative wound and fever after his 2 root apex was resected. He was referred to our department for further workups of fever and controlling the bleeding and was admitted on the spot. Intraoral findings revealed that the area was packed with spongel and bosmin gauze and that the amount of bleeding was minimal. The nearby gingivae were swollen and the lips were slightly anemic. CBC on admission reported the following values: RBC 188×104/mm3; Hgb 6.3g/dl; Hct 18.5%; PLT 6.1×104/mm3; WBC 59, 700/mm3, 81% myeloblasts, 12.5% promyelocytes, 1% myelocytes. Chromosomal study revealed the presence of 46 XY t (15;17). Based on some other studies, the diagnosis of APL or M3 variant according to the FAB classification, associated with DIC was established. A complete remission resulted after courses of DNR therapy. A temporary denture has been put in after the extraction of 32 tooth. His clinical course has been uneventful without bleeding tendency.