Atypical Presentation of Acute Lymphoid Leukemia in Child: Case Report
Introduction: Acute lymphoblastic leukemia (ALL) is the most common malignant neoplasm in children and the leading cause of cancer death in this age group. Hypercalcemia associated with frank osteolytic lesions is a rare presentation of ALL. Case Report: 9-year-old male, 37 kg, presented with headac...
| Autores: | , , , |
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| Formato: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2019 |
| País: | Brasil |
| Recursos: | Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
| Repositorio: | Revista Brasileira de Cancerologia (Online) |
| Idioma: | portugués inglés |
| OAI Identifier: | oai:rbc.inca.gov.br:article/190 |
| Acesso em linha: | https://rbc.inca.gov.br/index.php/revista/article/view/190 |
| Access Level: | acceso abierto |
| Palavra-chave: | Leucemia-Linfoma Linfoblástico de Células Precursoras Hipercalcemia Diagnóstico Precoce Criança Precursor Cell Lymphoblastic Leukemia-Lymphoma Hypercalcemia Early Diagnosis Child Diagnóstico Precoz Niño |
| Resumo: | Introduction: Acute lymphoblastic leukemia (ALL) is the most common malignant neoplasm in children and the leading cause of cancer death in this age group. Hypercalcemia associated with frank osteolytic lesions is a rare presentation of ALL. Case Report: 9-year-old male, 37 kg, presented with headache, pain and functional impotence in the lower right leg for 15 days. Laboratory tests showed elevation of erythrocyte sedimentation rate and C-reactive protein with hypercalcemia. Imaging studies revealed bone demineralization and diffuse osteolytic lesions. Bone marrow aspiration showed 10% of blasts, which did not characterize leukemia. Due to the improvement of his clinical condition, the patient continued the clinical investigation as an outpatient. Biopsy of lytic lesion in the hip and new bone marrow aspirations detected higher number of blasts and confirmed the diagnosis of ALL. Treatment was initiated, following the protocol of the Brazilian Group of Treatment of Leukemia in Childhood, 2009. After two years, he was well and without disease. Conclusion: Hypercalcemia is associated with only 0.6% to 4.8% of all ALL cases. The patient presented only diffuse bone pain and hypercalcemia, without the usual symptoms, which makes his clinical condition even rarer, with such presentation being very scarce in the literature. Although uncommon, hypercalcemia and diffuse osteolytic lesions may be the first and only manifestations of ALL in the pediatric range. The present report is important in helping to formulate early diagnosis of childhood leukemia, even in the presence of an atypical clinical condition. |
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