Granulocytic Sarcoma Manifesting as Otomastoiditis, Facial Nerve Paralysis and Unilateral Hearing Loss

We report an 8-year-old boy with acute myeloid leukemia (AML) manifesting as granulocytic sarcoma (GS) in the parapharynx, right inner and middle ear, right external acoustic canal, right mastoid cells, parietal bone resulting conductive hearing loss, otomastoiditis and facial nerve palsy. After chemotherapy; facial nerve functions improved, conductive hearing loss disappeared and parietal bone involment resolved. At the sixth month of admission, facial nerve function was fully intact, the right tympanic membrane appeared essentially normal. Because extramedullary leukemic tumors are uncommon, we would like to emphasize that leukemia might be an etiological factor in patients who present with otomastoiditis, facial nerve paralysis and unilateral hearing loss. It is appropriate for an otorhinolaryngologist to consider complete blood count, peripheral blood smear and temporal bone imaging to exclude any other systemic disease like leukemia, especially before steroid administration.