Introduction
Oral symptoms are often the first manifestation of leukemia in children,
and there are many reports of tooth extraction for abnormalities such as
tooth movement. Leukemia accounts for 38% of all childhood cancers in
Japan, followed by brain tumors (16%), lymphomas (9%), and
neuroblastomas (AML) (8%), and the remaining 5% are unknown. Among the
types of acute lymphoblastic leukemia (ALL), B-cell acute lymphoblastic
leukemia (B-ALL) accounts for 80–85% and T-cell acute lymphoblastic
leukemia (T-ALL) about 10–15%.1
Marukawa et al. reported that approximately 20–35% of leukemia
patients have initial symptoms in the oral cavity, and it is not
uncommon for oral symptoms to appear early in the course of leukemia.
The most common oral symptoms in leukemia patients are gingival
hemorrhage and gingival swelling, followed by jawbone abnormalities such
as miconus hypersensitivity, alveolar bone resorption, and tooth
movement, and many cases of leukemia have been detected in the oral
cavity.2-8
Curtis et al. reported a correlation between leukemia and mild or
worsening jaw bone symptoms in pediatric patients with ALL, based on
radiographic studies of jaw bone changes. However, there are no reports
of cases of jaw bone resorption in patients with ALL in Japan, although
there are a few reports of cases in which jaw bone resorption was
observed due to leukemia cell infiltration following the onset of
leukemia. No cases have been reported in which the jawbone was severely
resorbed.9, 10
In this study, we report a case of a pediatric patient with ALL who
developed leukemia and had significant jaw bone resorption due to
infiltration of leukemia cells, resulting in severe tooth movement and
the inability to properly occlude the jaw.