Acute Lymphoblastic Leukemia Presenting with Macrocephaly

Background: An eight-month old boy with the history of several admissions due to flu like symptoms was referred to our hospital with bicytopenia and significant growth in his head circumference. Observation: After several diagnostic measures the biopsy of the bone marrow was taken for the flowcytometry with the suspicion of hematologic malignancy which lead to the diagnosis of T-cell Acute lymphoblastic leukemia (ALL). The patient responded dramatically to the chemotherapeutic regimen. Conclusion: Although it is rare but macrocephaly can be a presenting symptom of T-cell ALL and this should be considered in differential diagnosis.