Bilateral Eye Proptosis and Right Temporal Orbital Region Swelling as First Presentation in Acute Myeloid Leukemia
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Abstract
Background: To describe a case of acute myeloid leukaemia (AML) presented with bilateral eye proptosis and swelling over the right temporal orbital region as first presentation.
Method: Case report.
Result: A 16-year-old Malay boy presented with bilateral eye proptosis and painless, progressive right temporal orbital region swelling for one month. It was associated with difficulty in passing urine and altered bowel habit. Three days prior to presentation he had lower back pain and numbness over bilateral lower limb which progressed to paraplegia two days after admission. On examination, the vision was 6/6 bilaterally with absence of relative afferent pupillary defect. There was axial proptosis in both eyes with restriction of extraocular movement in all gaze. Full blood picture showed bicytopenia with presence of 78% blast cells. Computed tomography of brain and orbit revealed hyperdense lesion at bilateral extraconal spaces and soft tissue swelling at right temporal orbital region. Magnetic resonance imaging of thoracolumbar has no significant findings. Bone marrow aspiration and trephine consistent with AML type M2/M4. He received radiotherapy and planned for chemotherapy but succumbed to his disease.
Conclusion: A child or young adult who presented with proptosis and rapidly growing orbital mass, high index of suspicion should be made against acute leukaemia as one of the differential diagnosis.
Conflict of interest: None.
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References
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