<p>Unilateral Proptosis As An Initial Sign Of Acute Myeloid Leukemia In A Child: A Case Report</p>

Abstract

Granulocytic sarcoma (chloroma) is a rare malignant solid tumor representing an extramedullary manifestation of acute myeloid leukemia (AML). Rarely, a chloroma can develop as the sole manifestation and its appearance may precede the systemic manifestations of acute myelocytic leukemia by months to years. We report a rare case of unilateral orbital mass presenting with progressive proptosis involving left globe in an otherwise healthy child, and give a brief overview of the literature about this unusual presentation. Leukemic infiltration should be considered in the differential diagnosis of orbital masses and proptosis even in the absence of systemic manifestations of AML. Early detection and management are crucial to preserve vision and prevent complications.

Acute Myeloid Leukemia Transformation from Myelofibrosis Upon Remission of an Orbital Myeloid Sarcoma – A Case Report

“…15 The common characteristics of orbital MS were proptosis, chemosis, orbital mass, and lid edema. 14 , 16 , 17 Ocular MS in adult AML patients was 10 out of 3,724 (0.3%) in the study, 17 whereas Cavdar et al reported 33 orbito-ocular MS in 133 Turkish children with AML. 18 The Children’s Oncology Group concluded that patients with MS involving orbital and central nervous system (CNS) sites had significantly better survival than patients with non-CNS MS, with CSF leukemia, or without extramedullary leukemia.…”

“…Myeloid sarcoma (MS) of orbit, presenting as malignant myeloid precursor cells invading orbital soft tissue, 13 might be the first manifestation of AML 14 or signify a relapse. It often involves bones and extends into the orbital fossa.…”

Bilateral Orbital Proptosis and Corneal Ulcer in a Child with Acute Myeloid Leukemia

“…Chefchaouni reported that 2% of children treated for leukemia suffered from proptosis [ 8 ]. Almaki et al [ 9 ] also reported a case of unilateral proptosis in a previously healthy child as an initial sign of acute myeloid leukemia. Such conditions should be considered in the absence of systemic leukemic manifestations as the form of granulocytic sarcoma (chloroma) [ 9 ].…”

“…Almaki et al [ 9 ] also reported a case of unilateral proptosis in a previously healthy child as an initial sign of acute myeloid leukemia. Such conditions should be considered in the absence of systemic leukemic manifestations as the form of granulocytic sarcoma (chloroma) [ 9 ]. However, our patient showed bilateral proptosis, which is a unique case of acute myeloid leukemia.…”

Isolated unilateral orbital myeloid sarcoma: a case report

“…and form soft tissue masses. 4 The direct infiltration of the orbits in leukemia can result in proptosis, chemosis, diplopia, lid edema, blurring of vision, palsies of the extra-ocular muscle, intra-retinal macular or sub-hyaloid hemorrhages, cotton wool spots, or papilledema due to the increased intracranial pressure. 5 Proptosis is the most common presentation of orbital MS. 3 Isolated unilateral proptosis as initial presentation of AML has been reported, wherein the bone marrow was positive for leukemic cells.…”