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Simultaneous conjunctival, uveal, and orbital involvement as the initial sign of acute lymphoblastic leukemia
Hayyam Kiratli1, Sevgül Bilgiç, Serkan Emeç
1Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey. hkiratli@hacettepe.edu.tr
Background:
A case of acute lymphoblastic leukemia with an initial presentation of unilateral simultaneous conjunctival, uveal, and orbital infiltration is reported.
Case:
A 9-year-old girl presented with mild proptosis and chemosis and total exudative retinal detachment in the right eye.
Observations:
B-mode ultrasonography showed diffuse uveal thickening and a retrobulbar mass. Magnetic resonance imaging scans demonstrated a well-circumscribed peribulbar orbital mass. Incisional biopsy from the conjunctiva and bone marrow sampling established the diagnosis of acute lymphoblastic leukemia L1 type.
Conclusion:
Blast-cell infiltration of three distinct ocular structures simultaneously in the absence of any peripheral signs is an extremely rare initial manifestation of acute lymphoblastic leukemia.
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