Bilateral Orbital Chloroma Revealing Acute Myeloid Leukemia: A Case Report

Chloroma is a rare extra-myeloid tumor composed of leukemia cells derived from granulomatous myeloid precursors. It occurs in only 2 to 8% of acute myeloid leukemia and rarely occurs in the orbital area. We report the case of an adolescent with no specific history, who consults for rapidly progressive bilateral exophthalmos. A blood count showed leukocytosis, bicytopenia and absence of cells blastics. Cranio-orbital computed tomography showed a bilateral multilobed orbital tumor process invading the oculomotor muscles and the optic nerve. Orbital biopsy confirmed the diagnosis of acute myeloid leukemia.

The positive diagnosis is guided by the blood count and confirmed by the biopsy of the orbital tumor and the myelogram. The radiological assessment is of interest in the evaluation of the tumor extent and post-treatment monitoring.

The treatment is based on chemotherapy and corticosteroid therapy combined or not with radiotherapy.