Acute myeloid leukemia first presentation with central nervous system (CNS) involvement: a case report

Background Acute myeloid leukemia (AML) typically presents with bone marrow myeloblast replacement, which can interfere with normal hematopoiesis. In rare cases, extramedullary involvement of myeloblasts can occur and affect various organs. When AML affects the central nervous system at the time of diagnosis, it is considered to be an unusual occurrence, with less than 5% of incidence. Case presentation A 19-year-old girl presented with progressively worsening frontal tension headache and blurred vision over a month. She also experienced sudden onset right eye strabismus and diplopia 25 days prior to her visit. Additionally, her complete blood count revealed pancytopenia. Following a thorough evaluation, including cytology and flow cytometry, of cerebrospinal fluid and bone marrow biopsy, she was diagnosed as AML with meningeal involvement. Conclusion Physicians should consider underlying malignancy in patients with meningeal symptoms, cranial nerve involvement, and/or resistance to conventional therapies.