Generalized gingival hyperplasia with ocular edema: An initial orofacial manifestation of acute myeloid leukemia with tumor lysis syndrome

Gingival hyperplasia with ocular involvement is a known presentation in hematological malignancies, including acute and chronic leukemias. Unusual presentation and lack of multidisciplinary approach lead to delays in diagnosis, disease-related complications, and death. We encountered a 41-year-old female who was initially diagnosed and treated by her dentist for gingival overgrowth for 4 weeks. During the course, she developed left ocular and lid edema. An ophthalmic examination, radiographic survey, and hematological screening revealed left ocular soft-tissue growth and a high white blood cell count. In our center, subsequent clinical, bone marrow, flow cytometry, and radiological workup revealed acute lymphoblastic leukemia with tumor lysis syndrome. This case emphasizes the importance of using a multidisciplinary approach to diagnose such diseases early to reduce morbidity and mortality, as a delayed diagnosis is no diagnosis.