Large Anterior Mediastinal Mass and Cardiac Infiltration at Diagnosis in a Child With T-cell Acute Lymphoblastic Leukemia.

While anterior mediastinal masses are a common presenting feature of T-cell acute lymphoblastic leukemia, cardiac leukemic infiltration is an exceedingly rare extramedullary manifestation. We report a 4-year-old female with new-onset T-cell acute lymphoblastic leukemia who was found to have a large interventricular septal mass upon initial presentation. This patient required a unique management approach with serial echocardiograms, continuous telemetry, and hemodynamic monitoring with close surveillance for ventricular ectopy. Given a good response to traditional leukemia therapy, the cardiac mass was presumed to have been a focal infiltrate of leukemic cells.

as reported in: Meyer EJ, Umaretiya P, Vrooman LM. J Pediatr Hematol Oncol. 2022 Mar:44(2):e418-e419. doi: 10.1097/MPH.0000000000002360.