Orbital Granulocytic Sarcoma (Chloroma) as Initial Manifestation Of Acute Myeloid Leukaemia

Abstract

Chloroma is an extramedullary manifestation of acute myeloid leukemia (AML). Chloroma may be found in a variety of locations throughout the body. The most common areas of involvement are the skin and the gums. Other tissues which can be involved include lymph nodes, small intestine, mediastinum, lung, epidural sites, uterus, ovaries and the orbit of the eye. A Chloroma is a solid tumor composed of immature white blood cells called myeloblasts. Children are affected more often than adults. There is a slight male predominance in these cases. The diagnosis is made by clinical examination, computed tomography and confirmed by haematological investigations. It may present at any time in the course of the disease. Diagnosis is particularly challenging in this situation. We report the case of a 11 year old male child who presented with bilateral exophthalmos (more in left eye) with computerized tomography (CT) evidence of a retro-orbital mass revealing acute myeloid leukemia. The patient was put on BFM-93 chemotherapy protocol. The patient has completed treatment of 1.5 years without relapse