Bilateral peripheral facial palsy and mastoid infiltration as symptoms of relapsed acute myeloid leukemia.
BACKGROUND
Although Bell's palsy (BP) is the most common cause of peripheral facial palsy (PFP), other etiologies merit investigation.


METHODS
A 60-year-old female patient presented with recurrent bilateral PFP. Although the patient had a history of acute myeloid leukemia (AML), she had initially been diagnosed with BP-related PFP and had been treated accordingly. When the PFP recurred, additional diagnostic tests were performed. The resulting immunohistochemical profile included CD3 positivity in a few reactive T lymphocytes; positivity for myeloperoxidase in atypical cells; and focal positivity for CD34 and proto-oncogene c-kit proteins in neoplastic cells, thus confirming the suspicion of mastoid infiltration caused by relapsed AML.


CONCLUSIONS
In patients with neoplastic disease, a finding of PFP calls for extensive investigation in order to rule out the involvement of the temporal bone.
Department of Otolaryngology and Head and Neck Surgery, Universidade Estadual de Campinas (Unicamp, State University at Campinas), School of Medical Sciences, PO Box 6111, CEP 13083-970, Campinas, SP, Brazil. Electronic address: silveirapriscila@hotmail.com.
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P
Leite da Silveira
Department of Otolaryngology and Head and Neck Surgery, Universidade Estadual de Campinas (Unicamp, State University at Campinas), School of Medical Sciences, PO Box 6111, CEP 13083-970, Campinas, SP, Brazil.
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V
Gonçalves Silva
Department of Otolaryngology and Head and Neck Surgery, Universidade Estadual de Campinas (Unicamp, State University at Campinas), School of Medical Sciences, PO Box 6111, CEP 13083-970, Campinas, SP, Brazil.
J
J
Rizzato Paschoal
Department of Otolaryngology and Head and Neck Surgery, Universidade Estadual de Campinas (Unicamp, State University at Campinas), School of Medical Sciences, PO Box 6111, CEP 13083-970, Campinas, SP, Brazil.
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Nizam Pfeilsticker
D005158:Facial Paralysis / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000175:diagnosis; D017254:Leukemic Infiltration / Q000209:etiology*; D008416:Mastoid / Q000473:pathology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications* / Q000175:diagnosis; D000090063:Proto-Oncogene Mas
Acute; Facial paralysis; Leukemia; Mastoiditis; Myeloid