# Acquired Submitral Aneurysm in an Adolescent with Relapse of B-cell Acute Lymphoblastic Leukemia and History of Multiple Systemic Infections: A Case Report

## TL;DR

A 14-year-old boy with a history of leukemia and infections developed a heart aneurysm, which was surgically repaired before cancer treatment.

## Contribution

This case highlights a rare complication of partially treated endocarditis in a leukemia patient leading to a submitral aneurysm.

## Key findings

- A submitral left ventricular aneurysm was found in a patient with a history of B-cell ALL and infections.
- The aneurysm was likely caused by partially treated endocarditis leading to mitral valve disruption.
- Surgical repair of the aneurysm allowed the patient to proceed with subsequent CAR-T cell therapy.

## Abstract

We present the case of a 14-year-old boy with history of B-cell acute lymphoblastic leukemia (ALL), multiple polymicrobial infections, and recent pericardial effusion requiring pericardiocentesis who was incidentally found to have a submitral left ventricular aneurysm. Concurrently, he developed a relapse of his B-cell ALL as demonstrated by the presence of lymphoblasts in his cerebrospinal fluid. The decision was made to proceed with surgical repair of the aneurysm prior to initiation of systemic chemotherapy. The patient underwent a successful repair of the aneurysm through repair of the mitral valve annular disruption. The aneurysm is likely to be due to partially treated endocarditis, weakening the mitral valve atrioventricular junction, resulting in dehiscence. Recovery post-operatively was uneventful and he was able to undergo CAR-T cell therapy several months later.