To the Editor.—Meningeal leukemia should be suspected when patients with acute leukemia complain of headaches, vomiting, blurred vision, excessive weight gain, stiff neck, lethargy, convulsions, or even coma.1,2
We have treated a child with acute leukemia in whom central nervous system (CNS) involvement was manifested by a unique symptom, a pulsating occipital mass.
Report of a Case
Acute lymphoblastic leukemia was diagnosed in a boy 8 years of age. Induction therapy with vincristine sulfate and prednisone was followed by maintenance therapy with mercaptopurine. The CNS involvement was not treated.Twenty-two months after diagnosis, he began to complain of headache, and a palpable nontender mass was noted on the posterior aspect of the skull. During the next nine months, he had one episode of right-sided hemiplegia with spontaneous recovery. Headaches, vomiting, and progressive sensory neural hearing loss with visual weakness and blurring were noted.Because of these complications, the
MUTZ ID, FISHER RG, HUMPHREY GB. Meningeal Leukemia Occurring as a Pulsating Occipital Mass. Am J Dis Child. 1974;127(6):909–910. doi:10.1001/archpedi.1974.02110250135024