Spontaneous remission of choroidal involvement by chronic myelomonocytic leukemia: a case report

TL;DR

A woman with chronic myelomonocytic leukemia experienced spontaneous regression of a choroidal lesion without intensive treatment.

Contribution

This case highlights that a 'watch and wait' approach may be effective for isolated ocular lesions in CMML.

Findings

The patient's choroidal lesion spontaneously regressed after biopsy.

The patient remained stable with no ocular involvement after 1.5 years.

A non-invasive follow-up strategy may be sufficient for isolated ocular lesions in CMML.

Abstract

Chronic myelomonocytic leukemia (CMML) is a rare hematological disorder characterized by variable risk of evolution to acute myeloid leukemia; to date, allogeneic stem cell transplantation is the only curative treatment. We report a case of choroidal involvement in a woman affected by CMML and presenting only with visual impairment. The patient was initially evaluated for an intensive therapeutic approach, but after biopsy the ocular lesion spontaneously regressed. Thus a “watch and wait” strategy was preferred. One year and a half after initial diagnosis, the patient is alive, with stable hematological disease and without any ocular involvement. Therefore, a close, not invasive follow up could be useful to tailor treatment for patients affected by single ocular lesions in CMML.

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