Orbital extramedullary myeloid tumor, or granulocytic sarcoma, can be difficult to diagnose even with the use immunohistochemical stains, especially if it precedes the development of systemic leukemia. We describe a 6-year-old boy with a rapidly progressive orbital tumor. This patient underwent an orbital biopsy, which was consistent with extramedullary myeloid tumor but not conclusive. Cytogenetic studies on a bone marrow biopsy revealed a translocation consistent with acute myelogenous leukemia.
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