Hypercalcaemia with disseminated osteolytic lesions: a rare presentation of childhood acute lymphoblastic leukaemia

Acute lymphoblastic leukaemia (ALL) presenting with hypercalcaemia and lytic bone lesions is a rare event in children unlike adults. We report a 15-year-old boy with acute lymphoblastic leukaemia and hypercalcaemia. He had normal peripheral blood count and the peripheral smear did not show blast. The bone marrow examination revealed Pre B ALL phenotype with aberrant expression of CD13. The skeletal survey showed osteolytic lesions. Hypercalcaemia was treated with zoledronic acid. He attained remission only after three lines of intensive chemotherapy protocols. He was planned for stem cell transplant. Meanwhile, he relapsed and died. A review of the literature also highlights characteristics similar to our case.