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Published on: February 29, 2020
[Burkitt's leukemia presenting as atypical acute mastoiditis in a 7-month-old child]
S Vigier1, R Nicollas, S Roman
1Service de chirurgie oto-rhino-laryngologique et cervico-faciale pédiatrique, université d'Aix-Marseille 2, hôpital de la Timone, 264, rue St-Pierre, 13385 Marseille cedex 5, France.
Abstract:
A 7-month-old girl presented with left acute mastoiditis and a white blood cell count of 79,000/mm(3). A surgically obtained bacteriological sample showed Streptococcus pneumoniae. Direct blood examination revealed leukemic blast cells. Histological samples showed leukemic infiltration of the left temporal bone. The final diagnosis was Burkitt's leukemia with left temporal bone leukemic infiltration. The patient received chemotherapy according to the LMB 2001 protocol from the Société française d'oncologie pédiatrique. Clinical, biological, and imaging follow-up 30 months after the end of treatment showed remission with complete recovery in the left temporal bone. Atypical presentation of acute mastoiditis (AM) should prompt investigation into whether there is a rare underlying pathology, such as a hemopathy, histiocytosis, or solid tumor. The first sign of leukemia may be acute middle ear disease. To our knowledge, no other cases of Burkitt's leukemia with temporal bone leukemic infiltration presenting as AM have been reported in a child under 1 year of age.
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