Orbital mass secondary to acute lymphoblastic leukaemia in a child: a rare presentation

Area of Science:

• Pediatric Oncology
• Ophthalmology
• Hematology

Background:

• Orbital masses in children can have diverse etiologies.
• Leukemia is a known cause of orbital tumors, but typically presents differently.
• Granulocytic sarcomas, associated with acute myelogenous leukemia (AML), are the common leukemic orbital masses.

Observation:

• A 3-year-old child presented with left eye swelling and proptosis.
• Systemic symptoms included fatigue, weight loss, hepatosplenomegaly, and lymphadenopathy.
• Peripheral smear and bone marrow biopsy confirmed blast cells.

Findings:

• CT scan revealed an infiltrative left orbital mass.
• The child was diagnosed with acute lymphoblastic leukemia (ALL).
• The orbital mass was secondary to ALL, preceding systemic disease manifestations.

Implications:

• This case highlights a rare presentation of ALL with an orbital mass as the initial sign.
• It underscores the importance of considering ALL in pediatric orbital masses, even without overt systemic signs.
• The findings challenge typical associations between orbital masses and specific leukemia subtypes.