{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T10:01:33Z","timestamp":1771236093547,"version":"3.50.1"},"reference-count":14,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,12,20]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>Paediatric patients with acute myeloid leukaemia (AML) often present with symptoms associated with the disruption of normal haematopoiesis and subsequent cellular deficiencies. Periosteal reactions are common in paediatric leukaemia, but typically manifest as a thin, laminated pattern along long bones. Aggressive periosteal reactions are much less frequently seen. Here, we report a case of paediatric AML initially presenting with proptosis and periorbital swelling caused by aggressive, sunburst periosteal reactions surrounding the sphenoid and zygomatic bones. This unique presentation emphasises the importance of considering leukaemic infiltration in the differential for sunburst periosteal reaction in paediatric patients.<\/jats:p>","DOI":"10.1136\/bcr-2021-247506","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T05:26:09Z","timestamp":1640928369000},"page":"e247506","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Acute myeloid leukaemia presenting as proptosis in an infant"],"prefix":"10.1136","volume":"14","author":[{"given":"Mohammad Javad","family":"Niazmand","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Speckert","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Johnston","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"key":"2025082802524896000_14.12.e247506.1","first-page":"1066","article-title":"Proptosis is a pediatric dilemma","volume":"3","author":"Altonbary","year":"2015","journal-title":"Ann Pediatr Child Health"},{"key":"2025082802524896000_14.12.e247506.2","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/MPH.0b013e31815a0599","article-title":"Malignant childhood proptosis: study of 104 cases","volume":"30","author":"Bakhshi","year":"2008","journal-title":"J Pediatr Hematol Oncol"},{"key":"2025082802524896000_14.12.e247506.3","article-title":"Primary tumors underlying unilateral orbital proptosis in children","volume":"58","author":"Goldenberg-Cohen","year":"2017","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025082802524896000_14.12.e247506.4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2013\/975908","article-title":"A clinical update and radiologic review of pediatric orbital and ocular tumors","volume":"2013","author":"Rao","year":"2013","journal-title":"J Oncol"},{"key":"2025082802524896000_14.12.e247506.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjopt.2013.06.004"},{"key":"2025082802524896000_14.12.e247506.6","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24464"},{"key":"2025082802524896000_14.12.e247506.7","first-page":"20","article-title":"Topics in pediatric leukemia \u2013 acute myeloid leukemia","volume":"7","author":"Cheng","year":"2005","journal-title":"Medscape Gen Med"},{"key":"2025082802524896000_14.12.e247506.8","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.220962"},{"key":"2025082802524896000_14.12.e247506.9","doi-asserted-by":"crossref","first-page":"455","DOI":"10.2214\/AJR.19.21833","article-title":"Imaging musculoskeletal manifestations of pediatric hematologic malignancies","volume":"214","author":"Tannenbaum","year":"2020","journal-title":"AJR Am J Roentgenol"},{"key":"2025082802524896000_14.12.e247506.10","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.3300"},{"key":"2025082802524896000_14.12.e247506.11","doi-asserted-by":"crossref","first-page":"101475","DOI":"10.1016\/j.epsc.2020.101475","article-title":"Pediatric primary orbital rhabdomyosarcoma","volume":"59","author":"Thien","year":"2020","journal-title":"J Pediatr Surg Case Rep"},{"key":"2025082802524896000_14.12.e247506.12","first-page":"18","article-title":"Hyperostosis - an unusual radiographic presentation of Myelodysplastic Syndrome transformed to Acute Myeloid Leukemia","volume":"4","author":"Franco","year":"2010","journal-title":"J Radiol Case Rep"},{"key":"2025082802524896000_14.12.e247506.13","first-page":"319","article-title":"Unilateral proptosis as an initial sign of acute myeloid leukemia in a child: a case report","volume":"12","author":"Almalki","year":"2019","journal-title":"Int Med Case Rep J"},{"key":"2025082802524896000_14.12.e247506.14","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1038\/s41375-018-0071-7","article-title":"Successes and challenges in the treatment of pediatric acute myeloid leukemia: a retrospective analysis of the AML-BFM trials from 1987 to 2012","volume":"32","author":"Rasche","year":"2018","journal-title":"Leukemia"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-247506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:52:59Z","timestamp":1756374779000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-247506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":14,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,31]]},"published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1136\/bcr-2021-247506"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-247506","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]}}}