Unilateral Ptosis as Initial Manifestation of Acute Myeloid Leukemia

In Acute Myeloid Leukemia (AML), malignant clones of immature myeloid cells (primarily blasts) proliferate, replace bone marrow, circulate in blood and invade other tissues. The unique presentation of unilateral ptosis and unilateral eyelid swelling in AML has been reported during the present study. Case Report: A 7-year-old girl was encountered with progressively increasing unilateral right eyelid swelling and ipsilateral ptosis. There was no systemic manifestation of leukemia. Computed tomographic image reported right orbit anteromedial mass. A high total leucocytic count in cell blood count with low platelet, the bone marrow aspirate and biopsy showing leukemic blast cells confirmed the diagnosis of AML. After diagnosis, an orbital MRI was done, which revealed a mass lesion, antromedial of right orbit, related to soft-tissue tumor. The patient was treated by chemotherapeutic drugs associated with intravenous steroids.

Unilateral ptosis and eyelid swelling is an initial manifestation of AML that has not been reported previously. A peripheral blood smear with bone marrow aspirate and biopsy helps in the early detection of AML. We should consider AML in any orbital mass with unknown origin.