Question:medium
The most common malignant cause for bilateral proptosis in children is?
The most common malignant cause for bilateral proptosis in children is?
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Bilateral orbital chloroma (granulocytic sarcoma) is the malignant marker, and it belongs to AML.
Updated On: Jun 24, 2026
- Lymphoblastic lymphoma
- Rhabdomyosarcoma
- Acute lymphoblastic leukaemia (ALL)
- Acute myeloid leukaemia (AML)
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The Correct Option is D
Solution and Explanation
Two filters must both be satisfied: the lesion has to be cancerous, and it has to push out both eyes in a child. That combination points away from a single solid orbital tumour and toward a blood cancer that seeds both orbits.
The entity that does this is the chloroma, also called granulocytic sarcoma, a tumour-like collection of immature myeloid white cells. Chloromas love the orbit and frequently appear on both sides, producing bilateral proptosis in a child. Since chloromas are built from myeloid blasts, their appearance is a hallmark of acute myeloid leukaemia.
Check the distractors against the two filters. Rhabdomyosarcoma is the most common primary orbital cancer of childhood but is typically one-sided, so it fails the bilateral criterion. ALL is the most frequent childhood leukaemia overall, but the chloroma-driven bilateral orbital picture is the signature of the myeloid (AML) variety. Lymphoblastic lymphoma rarely presents as bilateral childhood proptosis. Thus the bilateral, malignant, chloroma-based presentation maps to AML.
\[\boxed{\text{Acute myeloid leukaemia (AML)}}\]
The entity that does this is the chloroma, also called granulocytic sarcoma, a tumour-like collection of immature myeloid white cells. Chloromas love the orbit and frequently appear on both sides, producing bilateral proptosis in a child. Since chloromas are built from myeloid blasts, their appearance is a hallmark of acute myeloid leukaemia.
Check the distractors against the two filters. Rhabdomyosarcoma is the most common primary orbital cancer of childhood but is typically one-sided, so it fails the bilateral criterion. ALL is the most frequent childhood leukaemia overall, but the chloroma-driven bilateral orbital picture is the signature of the myeloid (AML) variety. Lymphoblastic lymphoma rarely presents as bilateral childhood proptosis. Thus the bilateral, malignant, chloroma-based presentation maps to AML.
\[\boxed{\text{Acute myeloid leukaemia (AML)}}\]
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