Bilateral Nephromegaly Mimicking Nephroblastoma: A Rare Initial Presentation of Acute Lymphoblastic Leukemia in a Bangladeshi Child

Abstract

Bilateral renal enlargement at the time of diagnosis of acute leukemia is very unusual. More than half of pediatric acute leukemia patients show features like hepatomegaly, splenomegaly, pallor, fever, and bruising at the time of diagnosis, however renal infiltration and nephromegaly are common in advanced-stage pediatric patients. Here, we have described a rare and unusual presentation of Acute lymphoblastic leukemia, in an 11-month-old male infant from Bangladesh who presented with bilateral nephromegaly along with nodular skin lesion overhead. Initial peripheral blood film has normal findings and USG of abdomen report bilateral Wilm’s tumor but later on the infant developed abnormal blood counts and subsequently diagnosis of acute lymphoblastic leukemia was made based on bone marrow aspiration findings. Renal involvement of acute leukemia should be considered in a child presenting with unexplained bilateral renal enlargement with or without renal function abnormalities.