Oral manifestations of leukemia as part of early diagnosis.

Abstract Introduction The oral cavity can present the first clinical manifestations of leukemia and therefore, it is important to recognize their principal characteristics. Objective To identify clinical features in the mouth as part of the first clinical manifestations leukemia. Methods This was an integrative review, which gathers data from articles with oral manifestations of leukemias as their first clinical features. The studies included publications, such as case reports, case series, clinical research, or reviews with case reports. The variables considered were age, gender, localization of the lesion, characteristics of the lesions, time of evolution, type of leukemia, general clinical symptoms, diagnostic hypothesis and/or causal effect, laboratory tests, imaging tests and histopathological examinations of the mouth injury. Results A total of 31 studies were included, with a total of 33 individuals identified. There were 19 (57.57%) males and 14 (42.42%) females. The age range was from 1.6 to 74 years. Acute myeloid leukemia (72.72%) and acute lymphoid leukemia (18.18%) presented more oral manifestations as the first clinical signs of the disease. All individuals with leukemia presented lesions, such as ulcer, erosion, bleeding, ecchymosis, color change of the bluish or pale mucous membranes and areas of tissue necrosis. Hard tissue lesions were less frequent, being 6 (18.18%). Conclusion The first clinical manifestations of leukemia can be present in the oral cavity, mainly in acute myeloid leukemia. The principal oral tissues affected were gingival tissue, buccal mucosa and hard and/or soft palate. When hard tissues, such as the maxilla bone or mandible bone were affected, dental mobility was the principal clinical sign.