Medical history: The patient is healthy and has never had any other medical conditions. Recently, the patient suddenly developed swelling of the gums in both jaws. The lesions progressed rapidly, the patient was tired, and had a low fever of 38 degrees Celsius.

The patient was admitted to the provincial hospital for treatment, but after 5 days his condition became more serious so he was transferred to a central hospital.

Examination of the patient showed that the patient was conscious, tired, had pale skin and mucous membranes, and a fever of 38.5 degrees Celsius. The lesions were very special: the mouth was not closed, the mouth was open, only the two molars were touching, the gums of both jaws were severely infiltrated, and the teeth of both jaws were loose at grade 2 or 3.

Panoramic X-ray also shows a special image: the entire group of upper and lower molars on both sides are pushed out of the tooth socket (this is also the reason why the patient currently has an open mouth, with only the 2 innermost molars touching each other).

When seeing this severe gingival infiltrate, the doctor immediately thought of a malignant blood disease, consistent with the fourth syndrome (infiltrative syndrome) of acute leukemia.

Immediately, the patient was tested for acute blood count, the result was 140,000 G/l. After inviting a Hematology consultation, with in-depth tests, the patient was diagnosed with acute leukemia and was transferred to the appropriate specialist for treatment.

According to experts from Bach Mai Hospital, clinicians need to pay close attention to avoid missing injuries and promptly have the most appropriate and scientific diagnostic orientation.

Lesions in the oral cavity are extremely rich and diverse, often they are manifestations of a systemic disease, not simply diseases of the Dentistry specialty.

Thus, when faced with injuries in the oral cavity, we need to be very alert and consider carefully to make the right and timely decisions!