Relapsed acute myeloid leukemia presenting with myocardial hypertrophy and constrictive pericardial physiology

Extra medullary relapse (EMR) after stem cell transplantation can be seen up to 20% of acute leukemia patients (1). Moreover, EMR rarely occurs in the heart and there are few cases reporting cardiac relapses in leukemia (2-5). Despite exceedingly rare incidence during clinical follow-up, cardiac leukemic involvement can frequently detected microscopically in up to 40% of patients on postmortem examination (6). The ante mortem diagnostic process can be challenging because cardiac symptoms secondary to infections or chemotherapeutics are similar to the symptoms related with leukemic cardiac infiltration (7). We report a case of cardiac relapse in myeloid leukemia presenting with myocardial hypertrophy and constrictive cardiac physiology, that was diagnosed by pericardial biopsy.