Presenting Symptom Of Leukemia Research Articles

Leukemia cutis as the presenting symptom of acute myeloid leukemia: report of three cases

Leukemia cutis (LC), a rare cutaneous manifestation of leukemia, can precede, follow, occur concurrently with, or present in the absence of (aleukemic) systemic leukemia. Leukemia cutis is especially rare as the presenting symptom of leukemia and is associated with a poor prognosis. Although more commonly seen in acute leukemias of myeloid and monocytic lineage, lymphocytic/lymphoblastic leukemias can also involve the skin. Three cases of LC presented with diverse skin lesions ranging from an erythematous rash to violaceous macules and papules to subcutaneous nodules. One case clinically mimicked fixed drug eruption. All the patients had acute myeloid leukemia (AML). Lesions showed two overarching histologic patterns: atypical perivascular infiltrate or nodular dermal histiocytoid infiltrate. Our cases expressed myeloperoxidase (MPO), a helpful marker to distinguish myeloid from non-myeloid cells, and CD68, a monocytic marker frequently expressed in cutaneous AML. CD14, a marker of monocyte maturity, was negative. In the absence of systemic leukemia, common diagnostic tools for hematologic malignancies such as bone marrow biopsy and flow cytometry are non-contributory, making morphologic and immunohistochemical analysis of the skin lesions key to diagnosis.

Leukemia Cutis and Facial Nerve Palsy as Presenting Symptoms of Acute Lymphoblastic Leukemia

Leukemia cutis and facial nerve palsy are rare presenting symptoms of leukemia. This report describes a case of acute T-cell lymphoblastic leukemia (ALL) presenting with only these two symptoms, a presentation of ALL that, to our knowledge, has not been previously described. It serves to alert physicians to look for underlying malignancy in the setting of cutaneous findings associated with facial nerve palsy.

Myeloid sarcoma of the upper extremity causing compartment syndrome: a case report

Myeloid sarcoma, also known as chloroma, granulocytic sarcoma, or myeloblastoma, is a rare, solid neoplasm comprised of immature extramedullary granulocytic cells, seen most frequently as a manifestation of myeloid leukemia. It often occurs either as the presenting symptom of leukemia, or as the harbinger of leukemia to come several months later, developing at some point in the disease course of 2% to 8% of patients with acute nonlymphoblastic leukemia overall. When occurring in patients without overt systemic signs of leukemia, the average time to the development of systemic disease is less than 1 year.1,2 Common sites of disease include the soft tissues, skin, bone, and lymph nodes. Less commonly, myeloid sarcoma can be seen in the intestines, mediastinum, epidural space, uterus, or ovary.3-6 Myeloid sarcoma presenting in the extremities is extremely rare. In this report we detail the unusual presentation of a compartment syndrome as the index presentation of a myeloid sarcoma in the soft tissues of the upper extremity.

Facial palsy as the presenting symptom of acute myeloid leukemia in children: Three cases with stem cell transplantations

=Abstract= Facial palsy as the presenting symptom of leukemia is very rare, especially in acute myeloid leukemia. A review of the medical literature identified reports on 8 children with AML who had facial paralysis as the presenting sign. Whole brain irradiation (WBI) has been applied in most cases. We present the cases of 3 such children. Achieving a remission without WBI, the patients underwent stem cell transplantations (SCTs). Two patients remain event-free 52 months and 62 months after allotransplants. Facial palsy was the harbinger of leukemic relapse in one case after autotransplant. This patient is disease-free 59 months after unrelated SCT rescue. Facial palsy persisted in 2 cases. Allogeneic SCT without WBI may be an effective therapy in patients presenting with facial palsy. A brief review of the literature is presented here. (Korean J Pediatr 2009;52:713-716)

Facial Paralysis as a Presenting Symptom of Leukemia

Facial paralysis may occur as a complication of central nervous system leukemias in children, but it is rarely a presenting symptom. This report describes an 8-month-old child who presented with peripheral facial palsy, failure to thrive, anemia, and otitis media. Antibiotic and steroid treatment led to an improvement in the clinical condition, but not the paralysis. At readmission 3 weeks later, physical examination revealed bluish, firm, palpable masses on the scalp and facial areas, and laboratory and imaging studies confirmed the diagnosis of acute myeloid leukemia. This case should alert physicians to consider hematologic malignancies in children with facial paralysis.

Facial nerve paresis as the presenting symptom of leukemia

Leukemic involvement of the temporal bone is not uncommon and may present in a variety of ways including auricular or external canal skin lesions, red or thick tympanic membrane, middle ear effusions, otitis media, hearing loss or mastoiditis. Symptomatic facial nerve involvement, on the other hand, is extremely unusual. We discuss a pediatric patient whose sudden onset facial nerve paresis was the presenting symptom that led to her diagnosis of leukemia. At the time of mastoidectomy, a granulocytic sarcoma or chloroma was noted to be overlying the VIIth nerve.