A case of ATLL (adult T-cell leukemia/lymphoma) mimicking odontogenic infection

A case of adult T-cell leukemia/lymphoma (ATLL) in which cheek swelling was the initial symptom is presented. A 44-year-old man referred to our hospital with swelling in his right cheek, and a dental infection was suspected by a previous physician. Computerized tomographic scans and magnetic resonance imaging revealed tumorous lesions from the right alveolus of the maxilla to the anterior and posterior walls of the maxillary sinus. Anti–HTLV-1 antibodies were positive, and the level of sIL-2R was high; other laboratory test results were normal., based on immunohistochemical results on a specimen biopsy, the patient was diagnosed with a lymphoma-type ATLL. Immediately, the patient was treated in the department of hematologic medicine. After several courses of multiagent chemotherapy, 27 Gy radiation therapy was directed to the maxilla. However, remission was not achieved. Cord blood transplantation was subsequently performed, but his general condition gradually worsened until he died 7 months after his initial visit.