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Unusual presentation of more common disease/injury
CASE REPORT
Childhood acute lymphoblastic leukaemia relapse with atypical localised presentation mimicking ankle trauma in a 28-year-old man
  1. Charlie Weige Zhao1,
  2. Vinit Singh2 and
  3. Vasundhara Singh3
  1. 1 Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
  2. 2 Physiology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  3. 3 Hospital Medicine, Mount Sinai Hospital, New York, New York, USA
  1. Correspondence to Charlie Weige Zhao, weige.zhao{at}yale.edu

Abstract

Acute lymphoblastic leukaemia (ALL) is a common paediatric cancer with a tendency to relapse, usually within 3 years of remission. Most patients present with hepatomegaly, splenomegaly, pallor, fever and bruising. Localised muskuloskeletal presentation is extremely rare. Here, we present a case of leukaemia relapse in the bone marrow of a 28-year-old man 9 years after achieving remission, presenting only with ankle pain and normal routine labs besides mild hypercalcemia, and no signs of disease in common bone marrow biopsy sites. This highly localised presentation is unusual and would hopefully inform clinicians to have a high index of suspicion for relapse in an adult patient who has had childhood ALL.

  • haematology (incl blood transfusion)
  • malignant and benign haematology
  • paediatric oncology

https://doi.org/10.1136/bcr-2018-228541

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    Footnotes

    • Contributors CWZ, ViS and VaS contributed substantially to the conception of the work, acquisition of data, writing and editing the report and final approval. All authors agree to be accountable for all aspects of the work in terms of accuracy and academic integrity.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.