Isolated extramedullary relapse of acute lymphoblastic leukemia in the breast of an adolescent girl: radiologic findings and discussion

Abstract

We report a case of isolated extramedullary leukemia relapse in the breast of an adolescent girl. A 13-year-old girl with acute lymphoblastic leukemia in remission, post-chemotherapy and unrelated cord blood transplant, presented with a breast lump. US and mammography demonstrated a large hypervascular heterogeneous mass. Examination of tissue provided by US-guided core biopsy confirmed focal leukemic relapse. US is a commonly used diagnostic tool in children and adolescents with a breast mass, for both characterization and guided biopsy.

Breast leukemia: an update

“…On ultrasound, BL manifested typically as hypoechoic microlobulated or indistinct lesions. They were hypervascularized on color Doppler (7,13,45,64,66,67,71,94,112).…”

Isolated Breast Relapse of Early T-Cell Precursor Acute Lymphoblastic Leukemia after Stem Cell Transplantation: A Pediatric Case and Literature Review

“…Various treatments, including chemotherapy, radiotherapy, and second HSCT, have been attempted [3][4][5][6][7]10]. Local radiotherapy was applied in four of the six pediatric cases in this literature review.…”

“…However, isolated extramedullary relapse (iEMR) in those sites after hematopoietic stem cell transplantation (HSCT) is extremely rare [1,2]. Additionally, only a few cases of isolated breast relapse after HSCT, wherein the marrow maintained morphologic remission and full donor chimerism, have been reported in children [3][4][5][6][7].…”

Isolated myocardial relapse of Philadelphia-positive acute lymphoblastic leukaemia causing myocarditis: a case report

“…Leukaemic infiltration of the myocardium is a well described entity, being confirmed in up to 44% of patients at post-mortem examination; however, ante-mortem clinical diagnosis remains difficult and rare 3 , 4 . As a result, myocardial involvement in the absence of any other foci of relapse has only seldom been reported 5 , 6 . Here, we present an unusual and rare case of isolated gross intracardiac relapse of ALL in a patient presenting with chest pain and fevers.…”