Infant Acute Myeloid Leukemia Presenting as Acute Appendicitis: A Case Report

Introduction

Acute leukemia is among the most common malignancy in infancy and childhood. The distinction between lymphoblastic and myeloid leukemia is crucial for appropriate therapy. Acute myeloid leukemia (AML) is less common than lymphoblastic leukemia, but sometimes presents with equally nonspecific symptoms at initial diagnosis. Timely detection of the disease affects treatment and prognosis.

At initial diagnosis, leukemias are often recognized by the consequences of the pathologically altered blood cells: dysfunctional leukocytes cause susceptibility to infections, thrombocytopenia leads to petechiae or mucosal hemorrhage, anemia reduces the patients' physical resilience and causes pale skin coloration. Classic B symptoms (fever, night sweats, weight loss) are not regularly reported. Rarely, additional locoregional changes occur due to organ manifestations that ultimately lead to diagnosis. For example, AML via localized blast accumulation (myelosarcoma) can lead to swelling (e. g. orbita) or neurologic deficits (spine and spinal canal) at initial diagnosis. Manifestation via gastrointestinal tract complaints has also been described. Occasionally, appendicitis has occurred in children and adults as the first sign of AML. Myelosarcoma of the appendix has not yet been described in infancy.

Publication History

Article published online:
22 October 2021