A 70 year old male, suffering from myelodysplastic syndrome, transforming into acute nonlymphoblastic leukemia (ANLL), complained of difficulty in speech of 3 months’ duration and left migraine which had started 6 months previously. MRI did not reveal an intracranial lesion. At that time, his bone marrrow was infiltrated by leukemic blasts in percentage of 31% and blood tests showed hemoglobin 10.9 g/dL, hematocrit 35.1%, white blood cells count 17x10⁹/L (neutrophils 25%, lymphocytes 36%, monocytes 2%, promyelocytes 1%, metamyelocytes 2%, blasts 33%). Oral examination revealed an elevated mass at the left base of the tongue (fig. 1) and candidiasis on the hard palate (fig. 2) for which fluconazole had been administered. The differential diagnosis included malignant lymphoma or other malignant mesenchymal neoplasm. A biopsy was performed, together with a blood test and bone marrow aspiration.