Eyelid myeloid sarcoma heralding relapse of acute myeloid leukemia in a child: First report from India and literature review

Myeloid sarcoma (MS) refers to an extramedullary collection of immature cells of granulocytic series and occurs either in isolation or in association with myeloid malignancies, particularly acute myeloid leukemia (AML). We report a 16-year old girl with AML who was treated at our hospital with standard “7 + 3” induction chemotherapy and achieved morphological remission. She developed a small nodule below her right eyelid at day 10 of first consolidation chemotherapy with high-dose cytarabine. Eyelid lesion increased in size despite oral antibiotics. Peripheral blood did not show any blasts. However, bone marrow examination was consistent with relapsed AML. She was treated with salvage chemotherapy followed by allogeneic stem cell transplant. However, her disease relapsed 2 months later and she died. This is the first case of eyelid MS from India in which eyelid MS developed during chemotherapy for AML and heralded the subsequent disease relapse. Eyelid MS could be a sinister manifestation of AML. Literature regarding eyelid MS is discussed in brief.