Chloroma of the orbit as a presenting feature of acute myeloid leukemia in a four year old female child

A four year old female child presented with a painless swelling of the right lower lid for 25days, which was progressively increasing in size. On palpation, a firm nodular mass just above the inferior orbital margin was noted. MRI showed homogenous enhancing mass in the orbit. Progressive axial proptosis developed in 8 days, with inability to close the eye. Bone marrow aspiration at this stage revealed Acute Myeloid Leukemia. Chemotherapy was started. Bone marrow picture after 10days showed remission phase. Symptoms and signs began to regress. The child was discharged on maintenance chemotherapy; but was admitted 3weeks later with fever; the child expired after admission 2 days due to secondary infection.