Recidiva orbital da leucemia linfoide aguda LLA em crianças: relato de caso

Abstract

INTRODUCTION: The recurrence of childhood ALL involving the eyeball is a rare event, occurring in 2.2% of children. The presence of specific orbital and ocular lesions is associated with a higher frequency of bone marrow relapses and CNS involvement, leading to a lower survival rate. OBJECTIVES: Conduct a longitudinal observational analysis of cases of orbital recurrences of ALL in children undergoing treatment at a reference oncology hospital in Western Paraná. CASE REPORT 1: 1-year-old female patient, undergoing treatment for ALL, presented with a whitish lesion in her left eye. In consultation with an ophthalmologist, an alteration of the red reflex with vitritis was observed in the left eye, and in the right eye an elevated lesion suggestive of an intraocular mass was seen. After months of investigation, it was concluded that there was orbital recurrence of ALL, and treatment was initiated according to BFM-90 for recurrences. CASE REPORT 2: 2-year-old female patient, undergoing treatment for ALL, presented skin lesions, right periocular edema and divergent strabismus. MRI of the orbit showed diffuse thickening of the optic nerves in their intraconal and canicular segments and part of the cisternal path, suggestive of infiltration of the optic nerves by the underlying disease. After confirming the diagnosis of ALL orbital recurrence, treatment was carried out according to the BFM-90 protocol. CONCLUSION: Through this research, the importance of a thorough evaluation of ophthalmological signs and symptoms in patients diagnosed with ALL was evidenced, for an early diagnosis and treatment.