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Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) manifestations in a child are varied. We report a unique and rare presentation of acute lymphoblastic leukemia in a child who presented with frontal swelling involving bilateral upper lids. A previously healthy one-year-old girl presented with progressively increas...

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Autores principales: Hanapi, Maya sapira, Ghani, Siti-Ilyana, Sonny Teo, Khairy Shamel, Wan-Embong, Wan-Zuhairah, Ariffin, Nasir, Wan Hitam, Wan-Hazabbah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318090/
https://www.ncbi.nlm.nih.gov/pubmed/30648072
http://dx.doi.org/10.7759/cureus.3539
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author Hanapi, Maya sapira
Ghani, Siti-Ilyana
Sonny Teo, Khairy Shamel
Wan-Embong, Wan-Zuhairah
Ariffin, Nasir
Wan Hitam, Wan-Hazabbah
author_facet Hanapi, Maya sapira
Ghani, Siti-Ilyana
Sonny Teo, Khairy Shamel
Wan-Embong, Wan-Zuhairah
Ariffin, Nasir
Wan Hitam, Wan-Hazabbah
author_sort Hanapi, Maya sapira
collection PubMed
description Acute lymphoblastic leukemia (ALL) manifestations in a child are varied. We report a unique and rare presentation of acute lymphoblastic leukemia in a child who presented with frontal swelling involving bilateral upper lids. A previously healthy one-year-old girl presented with progressively increasing frontal swelling of seven months duration. An examination revealed erythematous, firm, nontender forehead swelling that extended up to the medial part of bilateral upper eye lids. The extraocular muscle movement was normal. The anterior segment and fundus examination were also normal in both eyes. Other systemic examination revealed multiple leukemic cutis on the scalp. The cervical lymph nodes were also palpable with hepatosplenomegaly. A full blood picture (FBP) showed the presence of leucoerythroblastic blood film with 62% blast cells. Flow cytometry and bone marrow aspiration confirmed the diagnosis. Computed tomographic (CT) scan images revealed multiple well-defined hyperdense lesions at the subcutaneous skull with the largest lesion at the anterior glabella. Upon diagnosis, the patient was started on chemotherapy and the swelling resolved after one month post treatment. Extensive forehead swelling is a rare manifestation of acute lymphoblastic leukemia. A high index of suspicion aided with diagnostic investigations could help the doctors arrive at a correct diagnosis and treatment.
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spelling pubmed-63180902019-01-15 Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia Hanapi, Maya sapira Ghani, Siti-Ilyana Sonny Teo, Khairy Shamel Wan-Embong, Wan-Zuhairah Ariffin, Nasir Wan Hitam, Wan-Hazabbah Cureus Ophthalmology Acute lymphoblastic leukemia (ALL) manifestations in a child are varied. We report a unique and rare presentation of acute lymphoblastic leukemia in a child who presented with frontal swelling involving bilateral upper lids. A previously healthy one-year-old girl presented with progressively increasing frontal swelling of seven months duration. An examination revealed erythematous, firm, nontender forehead swelling that extended up to the medial part of bilateral upper eye lids. The extraocular muscle movement was normal. The anterior segment and fundus examination were also normal in both eyes. Other systemic examination revealed multiple leukemic cutis on the scalp. The cervical lymph nodes were also palpable with hepatosplenomegaly. A full blood picture (FBP) showed the presence of leucoerythroblastic blood film with 62% blast cells. Flow cytometry and bone marrow aspiration confirmed the diagnosis. Computed tomographic (CT) scan images revealed multiple well-defined hyperdense lesions at the subcutaneous skull with the largest lesion at the anterior glabella. Upon diagnosis, the patient was started on chemotherapy and the swelling resolved after one month post treatment. Extensive forehead swelling is a rare manifestation of acute lymphoblastic leukemia. A high index of suspicion aided with diagnostic investigations could help the doctors arrive at a correct diagnosis and treatment. Cureus 2018-11-03 /pmc/articles/PMC6318090/ /pubmed/30648072 http://dx.doi.org/10.7759/cureus.3539 Text en Copyright © 2018, Hanapi et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Ophthalmology
Hanapi, Maya sapira
Ghani, Siti-Ilyana
Sonny Teo, Khairy Shamel
Wan-Embong, Wan-Zuhairah
Ariffin, Nasir
Wan Hitam, Wan-Hazabbah
Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia
title Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia
title_full Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia
title_fullStr Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia
title_full_unstemmed Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia
title_short Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia
title_sort extensive forehead swelling including the periorbital area in a child: a rare manifestation of acute lymphoblastic leukemia
topic Ophthalmology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318090/
https://www.ncbi.nlm.nih.gov/pubmed/30648072
http://dx.doi.org/10.7759/cureus.3539
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