ABSTRACT

Eyelid involvement is rarely seen in leukemia. In this study, the clinical characteristics and treatment results of an acute myeloid leukemia (AML) patient with bilateral upper eyelid involvement are presented. A 47-year-old male patient, who had been followed by hematology clinic with the diagnosis of AML for eight years, applied to our clinic with complaints of hardness, thickening and malformation of both upper eyelids in October 2008. From the history and past medical records of the patient, it was learnt that he had been diagnosed with AML in 2000 and he underwent allogeneic bone marrow transplantation in 2002. However, he had a relapse after 5 years. Before the patient applied to us, a systemic relapse and skin involvement in one extremity occurred and a course of chemotherapy was started. On ophthalmologic examination, his best-corrected visual acuity was 20/20 bilaterally, and the anterior and posterior segments were normal. There was a marked thickening, hardness and malformation in both upper eyelids. At histopathological examination, the incisional biopsy material was found to be consistent with leukemic cell infiltration. Thus, chemotherapy of the patient was re-arranged and his systemic therapy was maintained. At a follow-up visit two months later, it was observed that the eyelids had returned to normal. Various ophthalmologic manifestations, such as retinal hemorrhages, anterior-posterior segment or orbital involvement, can often be seen in leukemic patients. Eyelid involvement is rarely seen. These ophthalmologic findings may appear in patients with a known diagnosis of leukemia, but also they may be the presenting signs of the disease or relapse.