Spontaneous Remission Of Choroidal Involvement By Chronic Myelomonocytic Leukemia: A Case Report
Diral, E., Catalano, G., Cicinelli, M. V., Distefano, A., Mastaglio, S., Vago, L., Lupo Stanghellini, M. T., Bernardi, M., Ponzoni, M., Ciceri, F., & Carrabba, M. G. (2024). Spontaneous remission of choroidal involvement by chronic myelomonocytic leukemia: a case report. Frontiers in oncology, 14, 1399894. https://doi.org/10.3389/fonc.2024.1399894
View Original Source →Abstract
Chronic myelomonocytic leukemia (CMML) is a rare hematological disorder characterized by variable risk of evolution to acute myeloid leukemia; to date, allogeneic stem cell transplantation is the only curative treatment. We report a case of choroidal involvement in a woman affected by CMML and presenting only with visual impairment. The patient was initially evaluated for an intensive therapeutic approach, but after biopsy the ocular lesion spontaneously regressed. Thus a "watch and wait" strategy was preferred. One year and a half after initial diagnosis, the patient is alive, with stable hematological disease and without any ocular involvement. Therefore, a close, not invasive follow up could be useful to tailor treatment for patients affected by single ocular lesions in CMML.
Case Details
Disease Location
Eye
Personal Characteristics
65-year-old woman, severe covid-19 infection requiring intensive cared
Clinical Characteristics
Referred after a severe covid-19 infection requiring intensive care. The patient presented with 10-month persistent monocytosis, thrombocytopenia, and macrocytosis. A bone marrow evaluation was diagnostic for chronic myelomonocytic leukemia (cmml-0 dysplastic type). The patient complained of visual loss in her left eye; the dilated fundus evaluation showed mild vitritis and a hypopigmented choroidal lesion with exudative retinal detachment in the mid-temporal periphery. Imaging suggested an infiltrative lesion. Retino-choroidal biopsy, consistent with involvement by chronic myelomonocytic leukemia (cmml)
Remission Characteristics
One month later, a new ophthalmic evaluation revealed a spontaneous decrease in the lesion size. The cmml ophthalmic lesion completely disappeared one year after initial diagnosis
Treatment & Mechanisms
Clinical Treatment
Bone marrow aspiration, retino-choroidal biopsy.
Non-Clinical Treatment
None reported