Isolated unilateral orbital myeloid sarcoma: a case report
DOI:
https://doi.org/10.18203/2349-3291.ijcp20222124Keywords:
MS, Orbit, Acute myeloid leukemia, ProptosisAbstract
Myeloid sarcoma (MS) is a rare solid tumor consisting of immature myeloid cells occurring at an extramedullary site. It can present before, with, or after the manifestation of acute myeloid leukemia or other myeloproliferative diseases, and a few patients never develop bone marrow infiltration. Only a few isolated cases of pediatric orbital MS have been reported, and they are often misdiagnosed. We report a rare case of pediatric isolated orbital MS in a 5-year-old boy who presented with unilateral proptosis. The patient was diagnosed with MS based on MRI and Immunohistochemistry results. Subsequently the patient underwent chemotherapy supported with radiotherapy and showed significant response. Isolated orbital MS presents with clinical and radiological features which are often misleading, making the diagnosis difficult. Therefore, MS should be considered in the differential diagnosis of orbital masses and proptosis even in the absence of acute myeloid leukemia (AML).
References
Samborska M, Derwich K, Skalska-Sadowska J, Kurzawa P, Wachowiak J. Myeloid sarcoma in children- diagnostic and therapeutic difficulties. Contemp Oncol. 2016;20(6):444-8.
Zhou T, Bloomquist MS, Ferguson LS, Reuther J, Marcogliese AN, Elghetany MT et al. Pediatric myeloid sarcoma: a single institution clinicopathologic and molecular analysis. Pediatr Hematol Oncol. 2020;37(1):76-89.
Razem B, Raiteb M, El Mrini S, Slimani F. Orbital myeloid sarcoma misdiagnosed for subperiostal hematoma: a case report. J Med Case Rep. 2021;15(1):501.
Almalki AMJ, Alotaibi FA, Jabr HF, Mastan AR. Unilateral Proptosis as An Initial Sign of Acute Myeloid Leukemia In A Child: A Case Report. Int Med Case Rep J. 2019;24;12:319-23.
Shields JA, Bakewell B, Augsburger JJ, Donoso LA, Bernardino V. Space-occupying orbital masses in children. A review of 250 consecutive biopsies. Ophthalmology. 1986;93(3):379-84.
Manpreet S, Sagarika S, Pulkit R, Kalaivani J, Manpreet K, Pankaj G. Acute unilateral proptosis in childhood: suspect myeloid sarcoma. Rom J Ophthalmol. 2021;65(1):85-8.
Al Semari MA, Perrotta M, Russo C, Alkatan HM, Maktabi A, Elkhamary S, Crescenzo RMD, Mascolo M, Elefante A, Rombetto L, Capasso R, Strianese D. Orbital myeloid sarcoma (chloroma): Report of 2 cases and literature review. Am J Ophthalmol Case Rep. 2020;11:19:100806.
Rajput D, Naval R, Yadav K, Tungaria A, Behari S. Bilateral proptosis and bitemporal swelling: a rare manifestation of acute myeloid leukemia. J Pediatr Neurosci. 2010;5:68-71.
Maka E, Lukáts O, Tóth J, Fekete S. Orbital tumour as initial manifestation of acute myeloid leukemia: granulocytic sarcoma: case report. Pathol Oncol Res. 2008;14:209-11.
Zimmerman LE, Font RL. Ophthalmologic manifestations of granulocytic sarcoma (myeloid sarcoma or chloroma): the third Pan American association of ophthalmology and American journal of ophthalmology lecture. Am J Ophthalmol. 1975;80:975-90.
Da Fonseca Junior NL, Paves L, Nakanami DM, Seivas MT, Manso PG. Sarcoma granulocitico em orbita: relatode caso. Arq Bras Ofthalmol. 2005;68(4):557-60.
Siraj F, Kaur M, Dalal V, Khanna A, Khan AA. Myeloid sarcoma: a report of four cases at unusual sites. Ger Med Sci. 2019;9:15.
Templeton AC. Orbital tumours in African children. Brit J Ophthal. 1971;55:234-61.
Bakst RL, Dabaja BS, Specht LK, Yahalom J. Use of radiation in extramedullary leukemia/chloroma: guidelines from the international lymphoma Radiation Oncology Group. Int J Radiat Oncol Biol Phys. 2018;102(2):314-9.
