Bilateral proptosis as initial sign of acute myeloid leukemia: case report and review of literature

Abstract

Then complete blood count, CT head (Figure 2), MRI was done .and bone marrow biopsy 9 (Figure 3) was done. Based on the clinical findings and imaging study results, the differential diagnosis included leukaemia, lymphoma, metastatic neuroblastoma, and idiopathic orbital inflammation (inflammatory pseudotumor). The initial peripheral blood cell count revealed an elevated white ABSTRACT We report bilateral proptosis as the unusual initial presentation of Acute Myeloid Leukemia (AML) in a child. A six years child presented with a history of painless proptosis in the both eyes with fever within 15 days. Radiological investigations were showing infiltration of orbit with the metastatic tumour cell. AML was diagnosed with complete blood count and bone marrow biopsy. The presumptive diagnosis of leukemic infiltration of the orbit and EOM was made, and urgent radiotherapy, allopurinol with high doses of vitamin A, intrathecal methotrexate, and intravenous daunorubicin were instituted. Proptosis was started to decrease. We report this case as AML can rarely present in child as a bilateral proptosis due to leukemic infiltration. Radiation treatment should be considered as an urgent treatment modality for this rare condition.

Bilateral proptosis as an early manifestation of juvenile myelomonocitic leukemia in an African child

“…Only rare cases of bilateral MS of the orbit have been published, 6,7 and none in children with JMML. However, an anedoctical case of bilateral ocular involvement by JMML in a 1-year-old Japanese child, causing blindness was described.…”