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Subglottic acute lymphoblastic leukaemia

Shilpa Ojha1, Julian Gaskin2, Michael Saunders3

  • 1Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK.

BMJ Case Reports
|December 21, 2018
PubMed

Insights

A rare case of childhood leukaemia presented as a subglottic mass, mimicking recurrent croup. Early endoscopy is crucial for diagnosing this unusual extramedullary leukaemia presentation in children.

Area of Science:

  • Pediatric Oncology
  • Otolaryngology
  • Hematology

Background:

  • Acute lymphoblastic leukaemia (ALL) is a common childhood cancer.
  • Airway obstruction is a rare but serious presentation of ALL.
  • Recurrent croup is a common pediatric ENT diagnosis.

Observation:

  • A 1-year-old boy presented with a history of recurrent croup.
  • Endoscopic examination revealed a subglottic mass.
  • The mass was diagnosed as localised acute lymphoblastic leukaemia.

Findings:

  • This is the first reported case of localised ALL presenting as a subglottic mass in a pediatric patient.
  • The presentation mimicked croup, delaying definitive diagnosis.
  • Extramedullary leukaemia can manifest as a localized mass.

Implications:

  • Broaden the differential diagnosis for 'recurrent croup' in children.
  • Consider extramedullary leukaemia in children with persistent airway symptoms.
  • Maintain a low threshold for endoscopic evaluation in suspected cases.

Keywords:
malignant and benign haematologyotolaryngology / ENTpaediatric oncology

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