Bilateral exophthalmos indicative of acute myeloid leukemia: About two cases

Introduction: Acute myeloid leukemia (AML) is a systemic condition linked to malignant cloning of immature myeloid cells, which replaces the bone marrow and other tissues of the body. The presentation of bilateral proptosis in AML is rare but may be responsible for a poor visual prognosis. Two cases are being reported. Case 1: A 4-year-old boy presented with a quickly progressive bilateral proptosis associated with a chemosis and lagophthalmia at the right eye. CT scan images revealed mass occupying the supero-lateral orbital wall, causing proptosis. The leukemic blasts cells on bone marrow biopsy confirmed the diagnosis of AML. Chemotherapy brought remission of the disease despite the irreversible sequelae in the right eye. Case 2: A 5-year-old boy presented with bilateral proptosis that evolved in two months. The AML diagnosis was confirmed by the bone marrow biopsy and chemotherapy was immediately started. The result was marked by the total remission of proptosis with visual function preservation. Conclusion: Bilateral proptosis in AML is unusual. It could cause irreversible damage of eyes if diagnosis and treatment are delayed. Keywords: myeloid leukemia, bilateral proptosis, children blindness.