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Clinicopathologic Reports, Case Reports, and Small Case Series
January 2003

Bilateral Orbital Myeloid Sarcoma as Initial Sign of Acute Myeloid Leukemia: Case Report and Review of the Literature

Arch Ophthalmol. 2003;121(1):138. doi:10.1001/archopht.121.1.138

Most pediatric orbital tumors are unilateral, and little is mentioned in the literature of the frequency and differential diagnosis of bilateral pediatric orbital tumors. Acute myeloid leukemia (AML) can involve the orbit as a solid tumor termed myeloid sarcoma or chloroma.1-3 We herein describe a child who was seen with bilateral orbital tumors that were the initial manifestation of AML. A literature review suggests that leukemia might be the most likely diagnosis in a child with bilateral soft tissue orbital tumors, a point that has not been widely recognized.

Painless, progressive proptosis of the left eye developed in a previously healthy boy aged 25 months during the course of 2 weeks. Orbital magnetic resonance imaging (MRI) showed bilateral orbital tumors, and he was referred to the Oncology Service at Wills Eye Hospital, Philadelphia, Pa, for diagnosis and management.