Bilateral proptosis as initial sign of acute myeloid leukemia: case report and review of literature

We report bilateral proptosis as the unusual initial presentation of Acute Myeloid Leukemia (AML) in a child. A six years child presented with a history of painless proptosis in the both eyes with fever within 15 days. Radiological investigations were showing infiltration of orbit with the metastatic tumour cell. AML was diagnosed with complete blood count and bone marrow biopsy. The presumptive diagnosis of leukemic infiltration of the orbit and EOM was made, and urgent radiotherapy, allopurinol with high doses of vitamin A, intrathecal methotrexate, and intravenous daunorubicin were instituted. Proptosis was started to decrease. We report this case as AML can rarely present in child as a bilateral proptosis due to leukemic infiltration. Radiation treatment should be considered as an urgent treatment modality for this rare condition.