Pseudo-panuveitis as a harbinger for systemic leukemia recurrence.

Purpose To describe a patient with a history of pre-B cell acute lymphoblastic leukemia (pre-B ALL) in remission, who developed recurrent alternating intraocular pre-B ALL manifesting with pseudohypopyon, uveal mass, and serous retinal detachment. In multiple instances this constellation of ocular findings preceded systemic leukemia recurrence. Method Case report. Results A 29-year old man with history of pre-B cell acute lymphoblastic leukemia, in remission following a hematopoietic stem cell transplant, presented with pseudo-hypopyon, uveal lesions, and serous retinal detachment of the right eye. Comprehensive workup for infectious and inflammatory etiologies was unremarkable, and a bone marrow biopsy revealed systemic recurrence of leukemia. One year later, while again in remission, the patient developed a pseudo-hypopyon, uveal mass, and serous retinal detachment of the other eye. Repeat bone marrow biopsy showed impending leukemia relapse, which occurred 1 month later. Orbital radiation resulted in complete ocular resolution. Conclusions The constellation of pseudohypopyon, serous retinal detachment, and uveal mass (pseudo-panuveitis) should be recognized as a harbinger for systemic pre-B ALL recurrence.