Bilateral diffuse uveal melanocytic proliferation secondary to acute lymphoblastic leukemia: a case report
Abstract
Background: Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a very rare paraneoplastic syndrome that might present with carcinoma. We present a case of an atypical BDUMP secondary to acute B-cell lymphoblastic leukemia (ALL) and report management outcomes at six months follow-up.
Case presentation: A 14-year-old female patient with known B-cell ALL presented with blurred vision and headache. Ophthalmological examination revealed new-onset, multiple, round, and pigmented choroidal lesions. Based on the clinical presentation, the diagnosis of BDUMP was suspected. Screening for second malignancies was negative. After nine sessions of plasmapheresis, ophthalmologic examination showed stable, non-progressive retinal lesions with maintained vision and absence of retinal detachment or cataract.
Conclusion: This was a rare case of BDUMP in a young patient with a known case of ALL.
Keywords: acute lymphoblastic leukemiabilateral diffuse uveal melanocytic proliferationretina
References
- Machemer R. [On the pathogenesis of the flat malignant melanoma]. Klin Monbl Augenheilkd. 1966; 148(5): 641–652.
- Barr CC, Zimmerman LE, Curtin VT, et al. Bilateral diffuse melanocytic uveal tumors associated with systemic malignant neoplasms. A recently recognized syndrome. Arch Ophthalmol. 1982; 100(2): 249–255.
- Klemp K, Kiilgaard JF, Heegaard S, et al. Bilateral diffuse uveal melanocytic proliferation: Case report and literature review. Acta Ophthalmol. 2017; 95(5): 439–445.
- Gass JD, Gieser RG, Wilkinson CP, et al. Bilateral diffuse uveal melanocytic proliferation in patients with occult carcinoma. Arch Ophthalmol. 1990; 108(4): 527–533.
- O'Neal KD, Butnor KJ, Perkinson KR, et al. Bilateral diffuse uveal melanocytic proliferation associated with pancreatic carcinoma: a case report and literature review of this paraneoplastic syndrome. Surv Ophthalmol. 2003; 48(6): 613–625.
- Chahud F, Young RH, Remulla JF, et al. Bilateral diffuse uveal melanocytic proliferation associated with extraocular cancers: review of a process particularly associated with gynecologic cancers. Am J Surg Pathol. 2001; 25(2): 212–218.
- Rahimy E, Coffee RE, McCannel TA. Bilateral diffuse uveal melanocytic proliferation as a precursor to multiple systemic malignancies. Semin Ophthalmol. 2015; 30(3): 206–209.
- Mittal R, Cherepanoff S, Thornton S, et al. Bilateral Diffuse Uveal Melanocytic Proliferation: Molecular Genetic Analysis of a Case and Review of the Literature. Ocul Oncol Pathol. 2015; 2(2): 94–99.
- Miles SL, Niles RM, Pittock S, et al. A factor found in the IgG fraction of serum of patients with paraneoplastic bilateral diffuse uveal melanocytic proliferation causes proliferation of cultured human melanocytes. Retina. 2012; 32(9): 1959–1966.
- Jaben EA, Pulido JS, Pittock S, et al. The potential role of plasma exchange as a treatment for bilateral diffuse uveal melanocytic proliferation: a report of two cases. J Clin Apher. 2011; 26(6): 356–361.