Bilateral peripheral facial palsy and mastoid infiltration as symptoms of relapsed acute myeloid leukemia

Silveira, P. Leite da; Silva, V. Gonçalves; Paschoal, Jorge Rizzato; Pfeilsticker, Leopoldo Nizam

doi:10.1016/j.anorl.2013.09.003

Cited by 15 publications

(15 citation statements)

References 9 publications

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“…Howell et al . and Leite da Silveira et al . reported one adult patient with AML having mastoiditis and facial palsy at AML relapse.…”

Section: Discussionmentioning

confidence: 99%

“…In 1984, Todd and Bowman 11 published a case report of a child with atypical mastoiditis and facial palsy as presenting symptoms of AML. Howell et al12 and Leite da Silveira et al13 reported one adult patient with AML having mastoiditis and facial palsy at AML relapse. Our study is the first larger series of patients showing radiological signs of mastoid cell involvement in combination with facial palsy.…”

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confidence: 99%

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Presenting features and imaging in childhood acute myeloid leukemia with central nervous system involvement

Ranta

Palomäki

Levinsen

et al. 2017

Pediatric Blood & Cancer

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Central nervous system (CNS) involvement in childhood acute myeloid leukemia (AML) can manifest as leukemic cells in the cerebrospinal fluid, a solid CNS tumor, or as neurological symptoms.We evaluated the presenting symptoms and neuroimaging findings in 33 of 34 children with AML and CNS involvement at diagnosis in the period 2000-2012 in Sweden, Finland, and Denmark.Imaging was performed in 22 patients, of whom 16 had CNS-related symptoms. Seven patients, including all but two with facial palsy, had mastoid cell opacification, considered an incidental finding. The frequent involvement of the mastoid bone with facial palsy warrants evaluation in larger series.

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“…Howell et al . and Leite da Silveira et al . reported one adult patient with AML having mastoiditis and facial palsy at AML relapse.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Presenting features and imaging in childhood acute myeloid leukemia with central nervous system involvement

Ranta

Palomäki

Levinsen

et al. 2017

Pediatric Blood & Cancer

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“…The CLL can present with otologic symptoms in up to half of the affected persons, such as acute otitis media and acute mastoiditis. 10 However, it is important to keep in mind the possibility of temporal bone metastasis of CLL with unusual presentations, including facial paralysis and sensorineural hearing loss.…”

Section: Discussionmentioning

confidence: 99%

Temporal bone metastasis as a sign of relapsing chronic lymphocytic leukemia

Aljafar

Al-Suhibani

Al-Ahmari

et al. 2015

SMJ

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Otologic manifestations in chronic lymphocytic leukemia (CLL) are common presentations. However, temporal bone metastasis is rarely described as a sign of relapsing CLL. A 65-year-old male diabetic patient known to have CLL on remission presented to the outpatient otolaryngology clinic with a one month history of progressive bilateral otalgia and right otorrhea, despite multiple courses of antibiotics. He was admitted with suspicion of malignant otitis externa. Left ear showed large hemorrhagic bullae on the posterior segment of tympanic membrane. Left sided facial paralysis developed on the third day of admission. Full recovery of facial paralysis is achieved by 10 days course of corticotherapy. Histological examination of middle ear tissue biopsy showed infiltration by monotonous small lymphoid cells, showing round nuclei, condensed chromatin suggestive of CLL. Although rare, unusual otologic manifestations should raise the suspicion of a temporal bone metastasis as a sign of relapsing CLL.

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“…One of the rare causes of facial diplegia is leukemia. Facial diplegia has been reported as a neurologic manifestation of acute myeloid leukemia (AML)[ 1 2 3 ] and of acute lymphoid (lymphoblastic) leukemia (lymphoma). [ 4 5 6 7 ] Facial diplegia from leukemia may be due to mastoid infiltration,[ 1 ] due to leukemic meningitis,[ 8 ] or due to bilateral focal lesion of the facial nucleus.…”

Section: Introductionmentioning

confidence: 99%

“…Facial diplegia has been reported as a neurologic manifestation of acute myeloid leukemia (AML)[ 1 2 3 ] and of acute lymphoid (lymphoblastic) leukemia (lymphoma). [ 4 5 6 7 ] Facial diplegia from leukemia may be due to mastoid infiltration,[ 1 ] due to leukemic meningitis,[ 8 ] or due to bilateral focal lesion of the facial nucleus. Depending on the location of the infiltration with leukemic cells, the cerebrospinal fluid (CSF) may be normal or may show leukemic cells as well.…”

Section: Introductionmentioning

confidence: 99%

Facial Diplegia as Initial Manifestation of Acute, Myelomonocytic Leukemia with Isolated Trisomy 47, XY,+11[14]/46, XY[6]

Finsterer

Panny

2017

Journal of Neurosciences in Rural Practice

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Bilateral peripheral facial palsy (facial diplegia) has been repeatedly reported as a neurologic manifestation of acute myeloid leukemia but has not been reported as the initial clinical manifestation of myelomonocytic leukemia. A 71-year-old male developed left-sided peripheral facial palsy being interpreted and treated as Bell's palsy. C-reactive protein (CRP) and leukocyte count 4 days later were 2.5 mg/l and 16 G/l, respectively. Steroids were ineffective. Seven days after onset, he developed right-sided peripheral facial palsy. Three days later, CRP and leukocyte count were 234.3 mg/l and 59.5 G/l, respectively. Cerebrospinal fluid investigations revealed pleocytosis (62/3) and elevated protein (54.9 mg/dl). Two days later, pleocytosis and leukocytosis were attributed to myelomonocytic leukemia. Leukemic meningeosis was treated with cytarabine and methotrexate intrathecally. In addition, cytarabine and idarubicin were applied intravenously. Under this regimen, facial diplegia gradually improved. Facial diplegia may be the initial clinical manifestation of myelomonocytic leukemia, facial diplegia obligatorily requires lumbar puncture, and unilateral peripheral facial palsy is not always Bell's palsy. Patients with alleged unilateral Bell's palsy and slightly elevated leukocytes require close follow-up and more extensive investigations than patients without abnormal blood tests.

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Bilateral peripheral facial palsy and mastoid infiltration as symptoms of relapsed acute myeloid leukemia

Abstract: In patients with neoplastic disease, a finding of PFP calls for extensive investigation in order to rule out the involvement of the temporal bone.

Cited by 15 publications

References 9 publications

Presenting features and imaging in childhood acute myeloid leukemia with central nervous system involvement

Presenting features and imaging in childhood acute myeloid leukemia with central nervous system involvement

Temporal bone metastasis as a sign of relapsing chronic lymphocytic leukemia

Facial Diplegia as Initial Manifestation of Acute, Myelomonocytic Leukemia with Isolated Trisomy 47, XY,+11[14]/46, XY[6]

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