RETINAL-DETACHMENT IN A CHILD AS THE FIRST SIGN OF LEUKEMIC RELAPSE -HISTOPATHOLOGY, MRI FINDINGS, TREATMENT, AND TUMOR-FREE FOLLOW-UP

Improved leukemia therapies in children have brought about prolonged r emissions with extramedullary relapses being reported in sites other t han the most common (bone marrow, testes, brain, and spinal cord). A 3 -1/2year-old boy with a history of acute lymphocytic leukemia presente d with total retinal detachment in one eye. Painful glaucoma unrespons ive to medical therapy necessitated enucleation. Histopathologic exami nation documented the presence of a dense leukemic cellular infiltrate replacing a totally detached, necrotic retina, Tumor cells also were present in the optic nerve. The child had remained free of leukemia fo r 3 years after systemic and intrathecal chemotherapy, supplemented by craniospinal radiation. This represents the first case of relapse of acute lymphocytic leukemia presenting solely as a retinal detachment. Our case also under-scores the point that the treatment of leukemia af ter an isolated ocular relapse can be associated with a favorable outc ome.