Orbital tumor preceded the development of acute myeloid leukemia: A case report and literature review

Acute myeloid leukemia (AML) may rarely involve the orbit as a solid tumor termed granulocytic sarcoma (GS). Orbital GS is a localized tumor consisting of immature myeloid cells. The histological diagnosis is difficult especially in patients with poorly differentiated tumors with no evidence of systemic leukemia. Special stains and immunohistochemistry have a significant role in the diagnosis. This report describes the case of a 14-year-old boy who presented with rapidly progressive unilateral proptosis which was found to be round cell tumor on histopathology. The diagnosis is made by clinical examination, computed tomography (CT), and confirmed by immunohistochemical findings. After 8 months, the patient developed AML with blast cells in the peripheral blood. The patient was treated by a combination of chemotherapeutic drugs. A literature review suggests that leukemia might be the most likely diagnosis in a child with orbital tumor and in many cases GS precedes the systemic manifestations of AML.