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Acute myeloid leukemia (AML) presenting as massive pericardial effusion is extremely rare and very few cases have been reported. We present the case of a 16-year-old boy who presented with massive pericardial effusion due to leukemic infiltration. He was diagnosed as AML M1. He received chemotherapy, achieved remission, and pericardial effusion resolved. After 15 months, he relapsed with the reappearance of pericardial effusion.
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