| 발표일자: |
2019년 11월 1일(금)~3(일) |
| 발표번호: |
P(e-poster)-392 |
| 발표장소: |
B3 Parking Area
|
|
|
| Orbital myeloid sarcoma as initial presentation of acute myeloid leukemia |
| Department of Ophthalmology, Hospital Sultanah Aminah, Johor Malaysia(1) |
| ChoonTeng Chan(1), Mohamad Fathi bin Ismail(1), Shalini Nganasekaran(1), F.M Vendargon(1) |
|
Purpose : To report an unusual presentation of acute myeloid leukemia.
Methods : Case report
Results : A 15-year-old healthy Malay boy complained of progressive right eye protrusion and reduced vision for two weeks duration. It was associated with eye redness and limited eye movement. He denied symptoms of bleeding tendency, fever, or anaemia. Other systemic review was unremarkable. Upon examination, there was unilateral right eye non-axial proptosis with limited extra-ocular movement in all gazes. The visual acuity of his right eye was 6/60 whereas left eye was 6/9. There was presence of relative afferent pupillary reflex of the right eye. Anterior segment examination of his right eye showed exposure keratopathy with lagophthalmos. Fundus examination of right eye showed optic disc pink and well defined, retina and macula were normal. The fellow eye examination was normal. Systemic examination showed presence of mild hepatosplenomegaly, other examination was normal. In spite of normal result for blood count, his full blood picture showed presence of 39% of blast cells. CT scan orbit showed right extraconal mass causing proptosis with periosteal elevation of right lateral orbital wall. Subsequently, the patient underwent right debulking of tumour and HPE confirmed diagnosis of myeloid sarcoma. He was then treated by hematology team with chemotherapy. Unfortunately, his right eye exposure keratopathy worsened, he developed bacterial cornea ulcer and his vision became perceptive to light.
Conclusion : Acute myeloid leukemia is rarely presented with orbital mass as its first sign. It is crucial for ophthalmologist to perform complete physical examination and to do the necessary investigation to prevent misdiagnosis of a life-threatening illness.
|
| |