spontaneous remission of congenital leukemia: a case for conservative treatment

Abstract

A newborn infant with spontaneous remission of congenital leukemia cutis is described and a literature review of this uncommon phenomenon is provided. In view of the unusual and unpredictable behavior of this disease, chemotherapy should be withheld unless there is evidence of an 11q23 translocation or progressive disease. Otherwise, overall survival does not appear to be affected by adopting a conservative approach. Because of occasional late relapses, long-term follow-up is recommended. The biologic basis underlying spontaneous remission of congenital leukemia is unknown; therefore, molecular or molecular cytogenetic analysis of DNA obtained from a skin biopsy is recommended.

Case Details

Disease Location

Skin

Personal Characteristics

New born male

Clinical Characteristics

At birth, a single subcutaneous nodule was noted on his left cheek by the first week of life, multiple skin lesions of similar character had developed all over his body, the lesions were red to magenta and included macules, papules, and nodules from 4-30mm, the lesions were firm and moved freely over the subcutaneous tissue but were fixed to the skin bone marrow aspirate showed a slight increase in the proportion of monocytic cells skin biopsy showed scattered leukemic blast cells in the dermis, these were infiltrating and insinuating themselves around fat cells and blood vessels cells were stained with lysozyme, CD15, 45, and 68, indicating a myeloid myelomonocytic phenotype

Remission Characteristics

During the next few weeks, there was a gradual resolution of the skin nodules by 10 weeks, the cutaneous lesions were clinically undetectable at 26 months later, he remains well

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism proposed

Clinical Treatment

None reported

Non-Clinical Treatment

None reported