Orbital Myeloid Sarcoma in Acute Myeloid Leukemia: A Case Report

Document Type : Case Reports


Department of Radiation Oncology, Regional Institute of Medical Sciences, Imphal, Manipur, India


Orbital myeloid sarcoma is a common presentation in acute myeloid leukemia. A 6 years old girl child presented with progressive proptosis of the left eye for two weeks with associated redness, watering, and reduced vision in the left eye. Imaging showed the left extraconal lobulated avidly enhancing smoothly marginated lesion in the superolateral aspect. Histopathological examination showed leukemic infiltration. Bone marrow analysis confirmed the diagnosis of acute myeloid leukemia with maturation (AML, M2). The patient was treated with induction chemotherapy followed by prophylactic cranial irradiation and subsequent consolidation chemotherapy. The patient expired ten months after diagnosis. Orbital involvement by AML leads to poor survival, even after combination therapy. Patients with proptosis need to be evaluated for malignant conditions, specifically the pediatric age.


Main Subjects

[1]        Nagaraju RM. Chloroma of Orbit: A Rare Initial Presentation in A Case of Acute Myeloid Leukemia Rashmi M Nagaraju, Bhimarao. International Journal of Anatomy Radiology and surgery. 2015;4(3):27-9.
[2]        Jadhav T, Baveja P, Sen A. Myeloid sarcoma: an uncommon presentation of myeloid neoplasms; a case series of 4 rare cases reported in a tertiary care institute. Autopsy and Case Reports. 2021;11. https://doi.org/10.4322/acr.2021.339.
[3]        Huang YC, Wang SC, Chen SN, Jou JR. Bilateral acute proptosis as initial manifestation of acute myeloid Leukemia. Orbit. 2015;34(5):248-52. https://doi.org/10.3109/01676830.2015.1049371.
[4]        Samborska M, Barańska M, Wachowiak J, Skalska-Sadowska J, Thambyrajah S, Czogała M, et al. Clinical characteristics and treatment outcomes of myeloid sarcoma in children: The experience of the polish pediatric leukemia and lymphoma study group. Frontiers in Oncology. 2022;12:935373. https://doi.org/10.3389%2Ffonc.2022.935373.
[5]        Ansari S, Rauniyar RK, Dhungel K, Sah PL, Ahmad K, Gupta MK, et al. Acute myeloid leukemia presenting as bilateral proptosis and right temporal swelling. Oman Journal of Ophthalmology. 2014;7(1):35-7. https://doi.org/10.4103%2F0974-620X.127927.
[6]        Tumuluri K, Woo T, Crowston J, Healey PR, Gottlieb D, Maloof AJ. Bilateral leukemic orbital infiltration presenting as proptosis and narrow-angle glaucoma. Ophthalmic Plastic & Reconstructive Surgery. 2004;20(3):248-50.https://doi.org/ 10.1097/01.IOP.0000129018.17256.38.
[7]        AlSemari MA, Perrotta M, Russo C, Alkatan HM, Maktabi A, Elkhamary S, et al. Orbital myeloid sarcoma (chloroma): report of 2 cases and literature review. American Journal of Ophthalmology Case Reports. 2020;19:100806. https://doi.org/10.1016/j.ajoc.2020.100806.
[8]        Dai XZ, Wang LY, Shan Y, Qian J, Xue K, Ye J. Clinicopathological analysis of 719 pediatric and adolescents' ocular tumors and tumor-like lesions: a retrospective study from 2000 to 2018 in China. International Journal of Ophthalmology. 2020;13(12):1961-7. https://doi.org/10.18240%2Fijo.2020.12.18.
[9]        Noh BW, Park SW, Chun JE, Kim JH, Kim HJ, Lim MK. Granulocytic sarcoma in the head and neck: CT and MR imaging findings. Clinical and experimental otorhinolaryngology. 2009;2(2):66-71. https://doi.org/10.3342/ceo.2009.2.2.66.
[10] Murthy R, Vemuganti GK, Honavar SG, Naik M, Reddy V. Extramedullary leukemia in children presenting with proptosis. Journal of Hematology & Oncology. 2009;2(1):1-7. https://doi.org/10.1186/1756-8722-2-4
[11] Conneely SE, Stevens AM. Acute myeloid leukemia in children: emerging paradigms in genetics and new approaches to therapy. Current Oncology Reports. 2021;23(2):1-3. https://doi.org/10.1007/s11912-020-01009-3.