Anterior Chest Wall Bulging: A Rare Initial Manifestation of Acute Lymphoblastic Leukemia in a Child

Soheila Zareifar,Nader Shakibazad

doi:10.4172/2329-6917.1000215

Abstract

Acute lymphoblastic leukemia (ALL) has several clinical manifestations on the base of bone marrow infiltration and the extent of extra medullary involvement. Anterior chest wall bulging as an initial presentation is rare. The aim of this case report study is to present a 3.5 year-old-boy presented with anterior chest wall bulging without history of trauma since 1 month ago. Tc99m-MDP bone scan showed multifocal active bony pathology in sternum, lower thoracic and all lumbar vertebra and right sacral ala. Bone marrow aspiration and biopsy was in favor of acute precursor lymphoblastic leukemia, B cell type. Therefore, acute lymphoblastic leukemia has different initial presentation and anterior chest wall bulging can be a rare initial sign of acute lymphoblastic leukemia in children.

Highlights

Acute Lymphoblastic Leukemia (ALL) is the most common pediatric malignancy with a cure rate of about 80-90%. [1,2]
We reported a case of anterior chest wall bulging as a rare initial manifestation of acute lymphoblastic leukemia in a child
A 3.5 years old boy presented initially with anterior chest wall bulging since 25 days prior to admission without any history of trauma or injury (Figure 1)

Summary

Introduction

Acute Lymphoblastic Leukemia (ALL) is the most common pediatric malignancy with a cure rate of about 80-90%. [1,2]. We reported a case of anterior chest wall bulging as a rare initial manifestation of acute lymphoblastic leukemia in a child. A 3.5 years old boy presented initially with anterior chest wall bulging since 25 days prior to admission without any history of trauma or injury (Figure 1). Figure 1: 3.5 years old boy with anterior chest wall bulging. After that, he developed fever and bone pain especially at sternum. The patient had history of glucose-6-phosphate dehydrogenase deficiency He admitted for further evaluation in Amir Hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Bone scan become normal and chest wall bulging was improved

Result

Findings

Discussion