Myeloid sarcoma presenting with proptosis, ruptured globe, and facial swelling

Myeloid sarcoma (MS) is a rare malignancy of immature myeloid cells and/or monocytes that occur in an extramedullary site. It is frequently mistaken for small-round-blue cell tumors, in the absence of immunohistochemistry. A case report of an unusual presentation of MS with a ruptured globe at a tertiary setting of North-western Nigeria is presented. The patient was a 12-year-old girl with progressive bilateral proptosis and spontaneous rupture of the left eye. A histologic diagnosis of embryonal rhabdomyosarcoma was made, but she had a minimal improvement in her clinical condition following chemotherapy. Further review showed bone marrow myeloblasts >98%. The previous tissue biopsy was subjected to immunohistochemistry and found to be CD117 – strongly positive and CD34 – patchy positive. The conclusion was that of myeloid leukemic infiltration of orbital tissue MS. The patient abandoned the treatment due to caregiver fatigue and financial exhaustion.