Leukemia is the most prevalent malignancy of leukocytes and can occur in children and adults. Oral manifestations are part of the complexity of signs and symptoms in patients with leukemia and, in some patients, oral manifestations precede systemic manifestations. Oral signs of leukemia include spontaneous bleeding, gingival enlargement, and whiteness of the oral mucosa. Head and neck lymphadenopathy is common in patients with leukemia. Oral manifestations are the result of the direct invasion of immature cells in the oral cavity tissues or indirectly caused by the replacement of the normal blood cells for immature cells causing anemia, leucopenia, and thrombocytopenia. The dentist and axillary oral health care providers must be aware of the oral signs and symptoms that may suggest leukemia facilitating early diagnosis and indicated medical treatment of the patient.

In this case report a 10-year-old female with acute lymphocytic leukemia (ALL), with oral lesions appearing in the maxillary gingiva, is presented. This presentation emphasis the importance of the physical exam (intra-oral and extra-oral) as well as the manifestations of ALL in the head and neck regions.