A rare case of orbital involvement in myeloid sarcoma – Report of two pediatric cases from North India with review of literature

A 10-year-old boy presented with a history of swelling in the right eye; on ocular examination, there was proptosis with inferior dystopia in the right eye. Contrast-enhanced computed tomography (CECT) was suggestive of a heterogeneously enhancing solid mass in the right orbit. Another, 10-year-old boy presented with swelling in his left eye; on ocular examination, there was proptosis of 3 mm in his left eye. CECT revealed a well-defined extraconal tumor of soft-tissue density involving the superior aspect of the left orbit extending to the lateral orbit in the preseptal area. Fine-needle aspiration biopsy in both children revealed orbital granulocytic sarcoma that was linked to acute myeloid leukemia (AML) on hematological examination. Myeloid sarcoma (MS) is a rare neoplasm characterized by abnormal extramedullary proliferation of immature myeloid cells and is usually seen in association with AML. The most common prediction for this tumor is skin, orbit, bone, soft tissues, lymph nodes, and peritoneum. The incidence of MS in the pediatric population is up to 30%–40%. Orbit is the most common involved tissue in the pediatric population.