Proptosis in a child can often present a diagnostic dilemma. Several types of lesions may cause proptosis in a child [Table 1]. It is important to keep in mind a categorized differential diagnosis so that relevant investigations may be ordered to facilitate early diagnosis and treatment. One investigation that is most often overlooked in the rush to get a computerized tomography (CT) scan or biopsy is a peripheral blood smear examination. This examination can establish the diagnosis of acute myeloid leukemia (AML) in most cases of granulocytic sarcoma, even in the absence of systemic features.
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