H. Frimmel (Halle/S.)  

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5 Years  

Male  

Head-Eye and orbita  

neoplastic  

5 10/12 year-old boy. Treatment for ALL. Findings after a two-time hemopoietic stemm cell transplant. Now, double vision, discrete exophthalmus on the right side, incomplete oculomotor nerve paralysis on the right side.  

Lymphoblastic leukemia, the most common form of leukemia in children.  

<- view MRI 1

MRI 1: T2-transversal with fat saturation: Diffuse, signal intense mass in the retrobulbar space to the right around the lateral rectus muscle. Expansion to the tip of the orbital siphon.
The meningeal structures are not able to be distinguished for certain from the mass in the area of the optic nerve foramen and the optic nerve.






<- view MRI 2

MRI 2: T1-SE- transversal before contrast application : Mass with low signals in the right retrobulbar space.






<- view MRI 3

MRI 3: T1-SE transversal with fat saturation after contrast: Mass in the right retrobulbar space, expansion to the tip of the orbital siphon.
The meningeal structures are not able to be distinguished for certain from the mass in the area of the optic nerve foramen and the optic nerve.



 

Total constellation (Consens)  

In this case, with known underlying illness, this was an obvious finding. Intraorbital tumor of other cause.
Orbital pseudotumor - often only slight contrast media uptake.  

4 types of ALL - depending on cell/surface marker - are able to be categorized.
-B-cell ALL (70%)
-T-cell-ALL (20%)
-B-/T-cell-ALL (2%)
-0-cell-ALL (missing surface marker).  

N/A  

N/A  

1. Medline:
Sartor,K.
Neuroradiologie
Thieme-Verlag Stuttgart  

ALL, retrobulbary infiltration, retrobulbary mass, leukemia, retrobulbar, relapse, recidive, ALL, Acute Lymphatic Leucemia, child, childhood, pediatric radiology  

H Frimmel. Retrobulbar relapse at ALL. PedRad [serial online] vol 2, no. 11.
URL: www.PedRad.info/?search=20021119131646