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June 1974

Meningeal Leukemia Occurring as a Pulsating Occipital Mass

Author Affiliations

Children's Memorial Hospital University of Oklahoma Health Sciences Center Oklahoma City, OK 73126

Am J Dis Child. 1974;127(6):909-910. doi:10.1001/archpedi.1974.02110250135024

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

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