Question:
Which of the following most commonly presents with bilateral proptosis in children?
Which of the following most commonly presents with bilateral proptosis in children?
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Bilateral orbital involvement in a child points to a myeloid leukaemic deposit, the chloroma.
Updated On: Jun 24, 2026
- Cavernous haemangioma
- Chloroma
- Fibrous histiocytoma
- Pleomorphic adenoma
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The Correct Option is B
Solution and Explanation
Step 1: Note the key word bilateral. Bilateral childhood orbital disease that is rapidly progressive suggests a process that seeds both orbits rather than a single localized tumour.
Step 2: Recognize the chloroma. A chloroma (granulocytic sarcoma) is an orbital deposit of myeloid leukaemic cells (associated with acute myeloid leukaemia). It characteristically affects children and commonly involves both orbits, causing bilateral proptosis.
Step 3: Exclude the localized adult-type tumours. Cavernous haemangioma is the commonest benign orbital tumour of adults and is typically unilateral and slow-growing. Pleomorphic adenoma is a lacrimal gland tumour of adults and is unilateral. Fibrous histiocytoma is also typically a unilateral, localized orbital lesion.
Conclusion: Among the listed lesions, the chloroma is the one that classically gives bilateral proptosis in children.
Step 2: Recognize the chloroma. A chloroma (granulocytic sarcoma) is an orbital deposit of myeloid leukaemic cells (associated with acute myeloid leukaemia). It characteristically affects children and commonly involves both orbits, causing bilateral proptosis.
Step 3: Exclude the localized adult-type tumours. Cavernous haemangioma is the commonest benign orbital tumour of adults and is typically unilateral and slow-growing. Pleomorphic adenoma is a lacrimal gland tumour of adults and is unilateral. Fibrous histiocytoma is also typically a unilateral, localized orbital lesion.
Conclusion: Among the listed lesions, the chloroma is the one that classically gives bilateral proptosis in children.
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