Illustration of an eye with a tumor on the eyelid, symbolizing a rare presentation of leukemia.

Rare Eye Tumors: When Leukemia Shows Up in the Eyelid

Kai Mendoza in Health & Wellness December 2025 • 4 min read.

"An unusual case highlights the importance of considering leukemia in the diagnosis of eyelid and conjunctival masses, even without typical blood abnormalities."

Leukemia, a cancer of the blood-forming tissues, can manifest in surprising ways. While often associated with systemic symptoms and abnormalities in blood counts, a recent case highlights a rare presentation: tumors in the eyelid and conjunctiva as the first sign of acute myeloid leukemia (AML).

AML, a type of cancer affecting the bone marrow and blood, can sometimes lead to the development of myeloid sarcoma, also known as granulocytic sarcoma or chloroma. This occurs when leukemic cells infiltrate tissues outside the bone marrow. These infiltrations can occur nearly anywhere in the body.

A recent case report underscores the importance of considering leukemia in the differential diagnosis of eyelid and conjunctival masses, even when initial blood tests appear normal. This article explores this unusual presentation of AML, drawing from a detailed case study.

The Case: Atypical Presentation of AML

Illustration of an eye with a tumor on the eyelid, symbolizing a rare presentation of leukemia.

The case involved an 82-year-old man who presented with bilateral conjunctival masses and a mass on his right eyelid. He had a history of prostate cancer treated with chemotherapy and stroke managed with carotid artery stent placement and medication.

Initial examinations, including blood tests, light reflex, extraocular muscle movement, and fundus examination, showed no specific abnormalities. His hemoglobin was 13.7 g/dL, and his leukocyte count was 5,530/mm³.

Neutrophils: 74.4%
Lymphocytes: 10%
Monocytes: 11.8%

A biopsy was performed one week after the initial visit. However, seven days post-biopsy, the patient experienced sudden dyspnea and fever, leading to admission to the intensive care unit. Subsequent laboratory tests revealed a significantly altered blood profile: hemoglobin at 9.6 g/dL and a leukocyte count of 78,020/mm³ with a high percentage of blasts (67%). The biopsy confirmed diffuse proliferation of atypical plasmacytoid cells, indicative of leukemic infiltration. Although chemotherapy was administered, the patient's condition deteriorated due to aggravated pneumonia, leading to death.

Key Takeaways and Clinical Implications

This case underscores the importance of considering systemic conditions like leukemia when evaluating eyelid and conjunctival masses. Even in the absence of typical blood abnormalities, a high index of suspicion is warranted.

While myeloid sarcoma is relatively rare, it should be included in the differential diagnosis of atypical eyelid and conjunctival lesions, especially in older adults with a history of cancer or other predisposing factors.

Further research is needed to better understand the pathogenesis and optimal management of myeloid sarcoma presenting in unusual locations. Early recognition and prompt treatment are crucial for improving patient outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3341/jkos.2016.57.5.843, Alternate LINK

Title: Case Of Acute Myeloid Leukemia With Mass Of Eyelid And Conjunctiva In The Early Stage

Subject: Ophthalmology

Journal: Journal of the Korean Ophthalmological Society

Publisher: Korean Ophthalmological Society

Authors: Dong Ju Kim, Min Wook Chang

Published: 2016-01-01

Everything You Need To Know

What is Acute Myeloid Leukemia (AML) and how does it relate to the eyelid tumors described?

Acute Myeloid Leukemia (AML) is a cancer originating in the bone marrow and blood. It is characterized by the uncontrolled production of abnormal blood cells. In the context of this case, it presented unusually, with tumors appearing on the eyelid and conjunctiva before typical blood abnormalities were evident. This atypical presentation highlights the need for careful consideration of AML in the diagnosis of eyelid and conjunctival masses.

What is Myeloid sarcoma and why is it important in this context?

Myeloid sarcoma, also known as granulocytic sarcoma or chloroma, is a solid tumor that can develop when leukemic cells infiltrate tissues outside the bone marrow. Its significance lies in its ability to manifest in various parts of the body, including the eyelid and conjunctiva, as seen in this case. The implications of myeloid sarcoma include the potential for misdiagnosis if not considered, especially when initial blood tests appear normal.

What are the conjunctiva and eyelid masses, and what was their significance in this case?

The conjunctiva is the clear membrane that covers the white part of the eye (sclera) and the inner surface of the eyelids. Eyelid masses refer to any abnormal growth or swelling on the eyelid. In this instance, the presence of masses on the eyelid and conjunctiva served as the initial presentation of Acute Myeloid Leukemia (AML). This unusual presentation emphasizes the importance of a high index of suspicion for systemic conditions like leukemia when evaluating such masses.

Why were blood tests important, and what did they initially show versus later?

Blood tests are crucial in diagnosing conditions like leukemia, but they may not always reveal abnormalities at the outset. In this case, the patient's initial blood tests did not show any specific abnormalities. However, a week later, a significantly altered blood profile emerged. This case highlights that it is critical to consider leukemia even when initial blood tests appear normal, as the disease can manifest in unusual ways before systemic signs are apparent.

What are the key takeaways and clinical implications of the unusual presentation described?

The clinical implications of this case are significant. It underscores the need for clinicians to consider systemic conditions like leukemia in the differential diagnosis of eyelid and conjunctival masses. Even if initial blood tests are normal, a high index of suspicion is warranted. This can lead to earlier detection and potentially more timely intervention, although the prognosis still depends on various factors including the type of leukemia and the patient's overall health.