Acute Myeloid Leukemia with Bilateral Proptosis as the Sole presenting Sign

Abstract

Acute myeloid leukemia (AML) accounts for nearly 15% of all leukemias in children¹. The leukemic cells can infiltrate any extramedullary site, tumorous accumulations within soft tissues and bones being labeled as granulocytic sarcomas. Granulocytic sarcoma (GS) or extramedullary leukemic deposits is an unusual manifestation of AML, accounting for about 3% of cases of AML. Bilateral proptosis is fairly common in association with acute and chronic lymphatic leukaemia, on the other hand myelogenous leukaemia rarely give rise to proptosis. Here we present a rare case of 4year old male child presenting as bilateral proptosis with no other manifestations of systemic malignancy at presentation. Radiological investigation, peripheral blood smear, bone marrow aspiration study was done for confirmation. The purpose of reporting such a rare entity is to highlight AML as a rare but important differential diagnosis of bilateral proptosis and emphasise the importance of peripheral blood smear in its diagnosis.