Aleukemic leukemia cutis presenting as a sole sign of relapsed pediatric acute lymphoblastic leukemia: Rare case report and review of literature

10^th Global Annual Oncologists Meeting

July 11-13, 2016 Cologne, Germany

Kshitij Candrakant Joshi, Harsha Panchal, Soniya parekh,Gaurang Modi,Avinash Talele,Asha Anand ,Urmila Uparkar,Nitin Joshi and Itesh Khatawani

Gujarat Cancer Research Institute, India

Posters & Accepted Abstracts: J Cancer Sci Ther

Abstract :

The author describes pediatric case of relapsed Acute lymphoblastic leukaemia (ALL) presented as Aleukemic leukemia cutis (ALC). A 2 year old child was admitted in tertiary oncology centre. He suffered from pre B cell ALL with absent Philadelphia chromosome. This patient received multi-agent induction chemotherapy as per Berlin-Frankfurt-Munster (BFM) protocol for ALL. He has achieved remission after 28 days of treatment. Subsequently he presented with multiple skin lesions in the form of multiple small erythematous violaceous macules, papules, plaques and nodules on face, chest and back regions. Histopathological examination of biopsy of skin revealed diffuse infiltration of tumor cells with prominent nucleoli, scant eosinophilic cytoplasm and numerous mitotic figures consistent with LC. Immunohistochemistry was positive for CD 10, CD 19, CD 22, CD 24, CD 79-a and TdT while negative for surface Immunoglobulin (sIg). At the time of presentation his peripheral blood smear and bone marrow examination was negative for malignant cells. Sanctuary sites including Central nervous system (CNS) and testicles were not involved. So patient was diagnosed as ALC. He was managed as per BFM relapse protocol for ALL. Skin lesions disappeared completely after 2 weeks of treatment. Unfortunately the patient developed bone marrow and testicular relapse after 2 months. He was given testicular radiotherapy and systemic chemotherapy for relapsed ALL. But his marrow was showing persistent activity and he expired after 4 months. Isolated cutaneous relapse is rare. This appears to be first reported case of pediatric B-cell ALL presented as ALC, as sole sign of relapse. ALC must be considered as one of the differential diagnosis of cutaneous lesions in ALL.

Biography :

Kshitij Chandrakant Joshi has completed his MBBS from MUHS & MD in General Medicine from VNSGU, India. He is currently a student of DM in Medical Oncology, Gujarat Cancer Research Institute, India. He has published many papers in reputed journals and presented oral papers and posters in many national conferences.

Eamil: kshitijcj27@yahoo.com