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Bilateral Acute Proptosis as Initial Manifestation of Acute Myeloid Leukemia
Ya-Chi Huang1, Shih-Chung Wang2, San-Ni Chen1,3
1a Department of Ophthalmology , Changhua Christian Hospital , Changhua , Taiwan .
Insights
Acute myeloid leukemia (AML) can present as orbital tumors in infants. This case report details the youngest patient with bilateral proptosis as the initial AML symptom, emphasizing prompt diagnosis.
Area of Science:
- Hematology
- Ophthalmology
- Pediatric Oncology
Background:
- Myeloid sarcoma is an extramedullary manifestation of acute myeloid leukemia (AML).
- Orbital leukemic tumors are more prevalent in children under ten.
- Early diagnosis of AML is crucial for effective treatment.
Observation:
- The youngest patient reported presented with bilateral proptosis as the initial sign of AML.
- The patient, an infant, exhibited no typical leukemic symptoms.
- Acute proptosis in infancy necessitates a thorough diagnostic work-up.
Findings:
- Bilateral proptosis can be an initial presentation of acute myeloid leukemia in infants.
- Peripheral blood smear and neuro-imaging are vital for diagnosing acute proptosis.
- Orbital masses in infants should be evaluated for potential AML, even without overt leukemic signs.
Implications:
- This case underscores the importance of considering AML in the differential diagnosis of orbital masses in infants.
- Prompt recognition and work-up of acute proptosis can lead to earlier AML diagnosis.
- Highlights the need for increased awareness among clinicians regarding rare AML presentations in pediatric patients.
Abstract:
The myeloid sarcoma is an extramedullary finding of acute myeloid leukemia (AML), and orbital leukemic tumors occur most commonly during the first decade of life. To our knowledge, we report the youngest patient with bilateral proptosis of both eyes as an initial manifestation of AML. This case highlights the need for peripheral blood smear and neuro-image work-up for acute proptosis in infancy. AML should be considered in the differential diagnosis of an orbital mass, even in the absence of typical leukemic symptoms.
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