title: Relapsed acute lymphoblastic leukemia with unusual multiple bone invasions: A case report.
abstract: The present study describes a unique pediatric case with multiple bone invasions of acute lymphoblastic leukemia (ALL) during remission. An eight-year-old male with a history of ALL was admitted complaining of intermittent and migrating pain in the limb 2 years following complete remission. Magnetic resonance imaging and whole-body positron emission tomography with18F-fluorodeoxyglucose revealed abnormal multifocal involvement in the bones and corresponding soft tissues. Repeated bone marrow (BM) aspiration indicated normal cellular marrow without leukemic cells, and marked leukemic cell infiltration in different sections of the ilium, respectively. These findings suggested isolated bone relapse, and it is probable that systematic BM relapse occurred as a consequence.
authors.affiliation: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Hangai
authors.affiliation: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shiozawa
authors.affiliation: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
authors.forename: Mitsuteru
authors.initials: M
authors.lastname: Hiwatari
authors.affiliation: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
authors.forename: Kohmei
authors.initials: K
authors.lastname: Ida
authors.affiliation: Department of Pediatrics, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Takita
keywords: acute lymphoblastic leukemia; bone relapse; computed tomography; positron emission tomography