Infantile leukemia presenting with cholestasis secondary to massive pancreatic infiltration

We present a 10-week-old infant who presented with cholestasis. Biliary obstruction secondary to massive pancreatic infiltration was demonstrated by ultrasound. A diagnosis of acute lymphoid leukemia was confirmed. Enlargement of the pancreas is unusual both in this age group and in leukemia. Infantile leukemia, although rare and usually not associated with gastrointestinal presentations, should be considered as a cause of pancreatic enlargement and neonatal cholestasis.