Relapse of acute lymphoblastic leukemia in the pancreas after bone marrow transplant

Background:Relapse of acute lymphoblastic leukemia(ALL)in the pancreas is rare.We report a case of a 12-year-old boy who experienced a relapse of ALL in the pancreas after a bone marrow transplant.Methods:Clinical data,including course of illness,laboratory results,and imaging studies are included.The patient presented with acute pancreatitis,suspected to be secondary to gallstones,with ampullary obstruction.Ultrasound and magnetic resonance imaging demonstrated a distended gallbladder and intra-and extra-hepatic biliary dilatation with a cutoff at the pancreatic head,but with no evidence of gallstones.Results:Ultrasound-guided biopsy of the pancreas revealed ALL in the pancreas.Systematic chemotherapy was recommended,but was declined by the parents.The patient died one week later.Conclusion:Relapse of ALL in the pancreas is rare,but when a history of ALL is present,it should be considered in patients with pancreatic enlargement,obstructive jaundice,and pancreatitis.