Isolated lacrimal gland enlargement as a presenting sign of relapse of B-cell acute lymphoblastic leukemia in an adult
Article Sidebar
Main Article Content
Abstract
A 25-year-old woman with a history of acute lymphoblastic leukemia with Philadelphia chromosome (BCR 22q11.2-ABL1 (9q34)) presented with two months of progressively worsening swelling and pain of her left upper eyelid. Magnetic resonance imaging showed a heterogeneously enhancing mass lesion in the left lacrimal gland. An incisional biopsy was performed; histopathology showed atypical lymphocytic cells and flow cytometry revealed a similar immunophenotype to her previously diagnosed cancer. Her presentation was consistent with recurrence of acute lymphoblastic leukemia in the lacrimal gland. The lacrimal gland can rarely be involved in relapse of acute lymphoblastic leukemia.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Redaelli A, Laskin BL, Stephens JM, et al. A systematic literature review of the clinical and epidemiological burden of acute lymphoblastic leukaemia (ALL). Eur J Cancer Care (Engl) 2005;14:53-62. DOI: https://doi.org/10.1111/j.1365-2354.2005.00513.x
Ward E, DeSantis C, Robbins A, et al. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin 2014;64:83-103. DOI: https://doi.org/10.3322/caac.21219
American Cancer Society. Cancer Facts and Figures 2022. 2022. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2022/2022-cancer-facts-and-figures.pdf.
Stary J, Zimmermann M, Campbell M, et al. Intensive chemotherapy for childhood acute lymphoblastic leukemia: results of the randomized intercontinental trial ALL IC-BFM 2002. J Clin Oncol 2014;32:174-84. DOI: https://doi.org/10.1200/JCO.2013.48.6522
Kantarjian HM, O’Brien S, Smith TL, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol 2000;18:547-61. DOI: https://doi.org/10.1200/JCO.2000.18.3.547
Paul S, Rausch CR, Nasnas PE, et al. Treatment of relapsed/refractory acute lymphoblastic leukemia. Clin Adv Hematol Oncolocy 2019;17:166-75.
Charif Chefchaouni M, Belmekki Z, Hajji H, et al. Ophthalmic manifestations of acute leukemia. J Fr Ophthalmol 2002;25:62-6.
Gaynon PS, Qu RP, Chappell RJ, et al. Survival after relapse in childhood acute lymphoblastic leukemia: Impact of site and time to first relapse—The Children’s Cancer Group experience. Cancer 1998;82:1387-95. DOI: https://doi.org/10.1002/(SICI)1097-0142(19980401)82:7<1387::AID-CNCR24>3.0.CO;2-1
Gabelli M, Zecca M, Messina C, et al. Hematopoietic stem cell transplantation for isolated extramedullary relapse of acute lymphoblastic leukemia in children. Bone Marrow Transplant 2019;54:275-83. DOI: https://doi.org/10.1038/s41409-018-0259-5
Fielding AK, Richards SM, Chopra R, et al. Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL): an MRC UKALL12/ECOG 2993 study. Blood 2007;109:944-50. DOI: https://doi.org/10.1182/blood-2006-05-018192
Nguyen K, Devidas M, Cheng SC, et al. Factors influencing survival after relapse from acute lymphoblastic leukemia: a Children’s Oncology Group study. Leukemia 2008;22:2142-50. DOI: https://doi.org/10.1038/leu.2008.251
Wilson J. Lymphatic leukemia with lacrimal gland involvement. Am J Ophthalmol 1948;31:1492.
Zhou XY, Behdad A. Relapse of an acute leukemia of mixed lineage as an isolated orbital mass. Blood 2017;130:953. DOI: https://doi.org/10.1182/blood-2017-04-781906
Diez-Feijoo Varela R, Salar A, Abella E, et al. Relapse of acute lymphoblastic leukemia mimicking Mikulicz syndrome during blinatumumab treatment: a case report. In: HemaSphere 2019;3:776-7. DOI: https://doi.org/10.1097/01.HS9.0000565256.38752.59
Denier M, Tick S, Dubois R, et al. Hidden in the eyes—recurrence of systemic hemopathies reportedly “in remission”: six cases and review of literature. Medicina (B Aires) 2022;58:456. DOI: https://doi.org/10.3390/medicina58030456
Cardone S, Yen MT, Chevez-Barrios P, et al. Recurrent acute lymphoblastic leukemia presenting in the lacrimal gland. Ophthal Plast Reconstr Surg 2006;22:56-7. DOI: https://doi.org/10.1097/01.iop.0000192644.97365.51
Johnston DL. Relapse of childhood acute lymphoblastic leukemia in the lacrimal gland. Med Pediatr Oncol 2003;40:337-8. DOI: https://doi.org/10.1002/mpo.10203
Silva D, Mota M, Bilé A, et al. Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse. GMS Ophthalmol Cases 2019;9:Doc16.
Rashid A, Lee NG, Jakobiec F, Freitag SK. Epstein-Barr Virus-positive polymorphous lymphoplasmacytic infiltrate of the lacrimal glands in a patient with acute lymphoblastic leukemia. JAMA Ophthalmol 2014;132:892-4. DOI: https://doi.org/10.1001/jamaophthalmol.2014.382