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• W4296613411 abstract "Leukemia cutis is the invasion of leukemic cells into the skin, resulting in identifiable cutaneous lesions. Leukemia cutis is associated with decreased overall survival and may signify the need for more intensive treatment of leukemia. Herein, we present a case of a patient who presented with syncope and hearing loss and was found to have leukemia cutis in his ear.A 42-year-old man with a past medical history of acute myelomonocytic leukemia in remission presented after an unwitnessed fall. He experienced hearing loss from the left ear for two weeks prior to presentation. His oncologic history of acute myelomonocytic leukemia was intermediate risk, NPM1 positive, FLT3 negative, and TKD positive; he received 7 + 3 induction chemotherapy two years prior, followed by high-dose cytarabine (HIDAC), and then maintenance midostaurin. His physical exam was notable for left sided ptosis and facial droop. His laboratory findings were notable for mild leukocytosis with neutrophilia. A CT scan of his head showed a large infiltrative mass, 6 cm by 5 cm by 10 cm, in the left skull base. Pathology demonstrated clusters of atypical monocytic and blastoid cells with irregular nuclei consistent with leukemic cutis. The blastoid cells were positive for CD33, CD4, and CD68 and negative for CD34 and MPO. He experienced acute worsening of vision, and ultimately blindness, over one week. He was evaluated by ophthalmology who performed a dilated fundus exam with findings of retinal hemorrhages at varying levels consistent with leukemic retinopathy. He experienced severe agitation and delirium as a result of losing his vision and hearing. His family ultimately decided to pursue comfort care, and he was discharged to inpatient hospice.Leukemia cutis is an extramedullary manifestation of leukemia and can commonly be confused with other cutaneous lesions. The diagnosis of leukemia cutis requires biopsy. It most commonly occurs in acute myeloid leukemia and typically presents with papules or nodules. The rapid progression of our patient's visual loss and hearing loss highlights the acuity of this manifestation of leukemia and the need for urgent treatment. Further studies on leukemia cutis are warranted to elucidate this aggressive malignancy." @default.
• W4296613411 created "2022-09-23" @default.
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• W4296613411 date "2022-10-01" @default.
• W4296613411 modified "2023-09-29" @default.
• W4296613411 title "AML-479 An Atypical Cause for Hearing Loss and Syncope: Leukemia Cutis of the Ear Secondary to Acute Myelomonocytic Leukemia" @default.
• W4296613411 doi "https://doi.org/10.1016/s2152-2650(22)01302-7" @default.
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