Intracranial Involvement of Chioroma: A Case Report

ABSTRACT

Chloroma is an unusual presenting feature of acute leukemia in childhood. These are found in relation to the periosteum of the skull, paranasal sinuses, orbits, vertebrae or ribs. Chloromas may occasionally produce central or peripheral neurologic disturbance, as this patient demonstrated. 9 year old girl entered this hospital with complaints of protrusion of left eye, headache and vomiting. A month prior to admission the parent noted slight protrusion of left eye which had progressed rapidly with development of another small mass in the scalp. On admission, the patient showed rather anemic somewhat dull mentality and moderate papilledema on right. Blood picture and biopsy of scalp mass revealed hematologic and cytologic features of leukemia. The girl has deteriorated rapidly and died on the 28th hospital day. Autopsy showed multiple chloromas in relation to the periosteum of orbital fossa, ribs, pelvis, and skull. There were four masses as large as one to two cm in diameter at the inner aspect of dura mata which were compressing the brain. It is rare in this country that the infiltration of chloroma on the dura mata was proved in autopsy.