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Acute myeloid leukaemia presenting as proptosis in an infant
  1. Mohammad Javad Niazmand1,
  2. Matthew Speckert2 and
  3. Donna Johnston2
  1. 1Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  2. 2Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
  1. Correspondence to Dr Donna Johnston; djohnston{at}


Paediatric patients with acute myeloid leukaemia (AML) often present with symptoms associated with the disruption of normal haematopoiesis and subsequent cellular deficiencies. Periosteal reactions are common in paediatric leukaemia, but typically manifest as a thin, laminated pattern along long bones. Aggressive periosteal reactions are much less frequently seen. Here, we report a case of paediatric AML initially presenting with proptosis and periorbital swelling caused by aggressive, sunburst periosteal reactions surrounding the sphenoid and zygomatic bones. This unique presentation emphasises the importance of considering leukaemic infiltration in the differential for sunburst periosteal reaction in paediatric patients.

  • paediatric oncology
  • paediatrics
  • haematology (incl blood transfusion)

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  • Contributors All authors: contributed to the manuscript as written, planning of the case report and review of the literature and acquisition of data and analysis of data. DJ and MS: directly provided care to the patient.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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