Orbital granulocytic sarcoma (chloroma)‎

Abstract EN

Objective : To report a case of orbital chloroma that preceded acute myelogenous leukemia, and to discuss its extra-cranial manifestation on computed tomography.

Methods : A nine-year-old boy from Yemen was referred in 1997 for acute progressive proptosis and decreased vision in his left eye.

At that time, physical examination, routine serological and blood examination revealed no abnormality.

Computed tomography of the brain and orbit showed a large lobulated non-enhancing nodular mass filling the left orbit without extracranial extension.

Six months later, myeloblasts appeared in the peripheral blood and bone marrow.

Results : Bone marrow aspirate revealed acute myelogenous leukemia without maturation French American British classification AML-Mj.

The patient was started on standard antileukemic therapy after which the orbital lesion improved dramatically and the patient achieved a complete hematological response.

Conclusion : Orbital chloroma is an unusual variant of granulocytic leukemia, which may appear before hematological evidence of leukemia.

This case demonstrates that early and accurate diagnosis is important to prevent inappropriate treatment and surgical intervention and stresses the need for vigorous antileukemic therapy.