Hemorrhagic enlargement of the mandibular gingiva

A 50-year-old woman sought treatment for a 4-month history of pain and bleeding of the mandibular anterior gingiva. She reported a swelling on the back of the mandibular anterior teeth that had increased in size over time. She also reported numbness and increased mobility of the mandibular anterior teeth that had begun 2 months earlier. The patient had self-medicated with 500 mg of acetaminophen without significant improvement of symptoms. Her medical history was significant for leukemia, in remission for 3 years after chemotherapy.