Aleukemic myeloid sarcoma of small intestine: masquerading as subacute intestinal obstruction: Review of literature
Keywords:
Myeloid sarcoma, Small intestine, Obstruction, Aleukemic, Myeloperoxidase, CD34
Abstract
Background: Myeloid sarcoma (MS) is an extramedullary disease of immature myeloid cells with incidence of 1-2% among all acute myeloid leukemia (AML) cases. Less than twenty cases of aleukemic MS with initial presentation as intestinal mass have been described in the English literature. Case report: Here we report a case of 45 year old female with normal haematology workup who presented with acute abdominal pain and distension. On evaluation, she was found to have ileocolic intussusception of gangrenous bowel, so managed by limited right hemicolectomy and initially reported as Non Hodgkin lymphoma (NHL).During follow-up she was found to have a globular mass in right lumbar region that was diagnosed as myeloid sarcoma. On further followup, her TLC count was gradually increasing. Conclusion: The index case highlights the unusual presentation of isolated intraabdominal MS which was clinical diagnosed as subacute intestinal obstruction in a young female with normal hematological profile.References
1. Burns A: Observations of Surgical Anatomy in Head and Neck. Thomas Royce and Company, Edinburgh, UK. 1811:364-66.
2. Tsimberidou, A.M., Kantarjian, H.M., Wen, S., Keating, M., O’Brien, S., Brandt, M. et al. Myeloid sarcoma is associated with superior event free survival compared with acute myeloid leukemia. Cancer 2008;113:1370-78.
3. Pileri, S.A., Ascani, S., Cox, M., Campidelli, C., Bacci, F., Piccioli, M. et al. Myeloid sarcoma: clinicopathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia 2007;21:340-50.
4. Vardiman, J.W., Thiele, J., Arber, D.A., Brunning, R.D., Borowitz, M.J., Porwit, A. et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood 2009;114:937-51.
5. Brunning RD, Matutes E, Flandrin G, et al. Acute myeloid leukaemia not otherwise categorised. In: Jaffe ES, Harris NL, Stein H, Vardiman JW, editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press 2001;22(8):104-05.
6. Burnett, A., Wetzler, M. and Lowenberg, B. Therapeutic advances in acute myeloid leukemia. J Clin Oncol 2011;29:487-94.
7. King A: A case of chloroma. Monthly J Med 1853;17:97.
8. Breccia M, Mandelli F, Petti MC, D'Andrea M, Pescarmona E, Pileri SA, Carmosino I, Russo E, De Fabritiis P, Alimena G. Clinico-pathological characteristics of myeloid sarcoma at diagnosis and during follow-up: report of 12 cases from a single institution. Leuk Res 2004; 28:1165-69.
9. Yu T, Xu G, Xu X, et al. Myeloid sarcoma derived from the gastrointestinal tract: a case report and review of the literature. Oncol Lett 2016;11:4155-9.
10. Venizelos ID, Frakandreas G, Tatsiou ZA, et al. Isolated myeloid sarcoma of the small intestine in an aleukemic Patient–Case Report and Review of the Literature. Visc Med 2008;24:171–4.
11. Stefanidakis, M., Karjalainen, K., Jaalouk, D.E., Gahmberg, C.G., O’Brien, S., Pasqualini, R. et al. Role of leukemia cell invadosome in extramedullary infiltration. Blood 2009;114: 3008-17.
12. Paydas, S., Zorludemir, S. and Ergin, M. SGranulocytic sarcoma: 32 cases and review of the literature. Leuk Lymphoma 2006;47:2527-41.
13. Yamauchi, K. and Yasuda, M. Comparison in treatments of nonleukemic granulocytic sarcoma: report of 2 cases and a review of 72 cases in the literature. Cancer 94: 1739-46.
14. Avni, B.R., Rund, D., Levin, M., Grisaro, S., Ben-Yehuda, D. and Paltiel, O. Clinical implicationsof acute myeloid leukemia presenting as granulocytic sarcoma. Hematol Oncol, in press. 2011.
2. Tsimberidou, A.M., Kantarjian, H.M., Wen, S., Keating, M., O’Brien, S., Brandt, M. et al. Myeloid sarcoma is associated with superior event free survival compared with acute myeloid leukemia. Cancer 2008;113:1370-78.
3. Pileri, S.A., Ascani, S., Cox, M., Campidelli, C., Bacci, F., Piccioli, M. et al. Myeloid sarcoma: clinicopathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia 2007;21:340-50.
4. Vardiman, J.W., Thiele, J., Arber, D.A., Brunning, R.D., Borowitz, M.J., Porwit, A. et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood 2009;114:937-51.
5. Brunning RD, Matutes E, Flandrin G, et al. Acute myeloid leukaemia not otherwise categorised. In: Jaffe ES, Harris NL, Stein H, Vardiman JW, editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press 2001;22(8):104-05.
6. Burnett, A., Wetzler, M. and Lowenberg, B. Therapeutic advances in acute myeloid leukemia. J Clin Oncol 2011;29:487-94.
7. King A: A case of chloroma. Monthly J Med 1853;17:97.
8. Breccia M, Mandelli F, Petti MC, D'Andrea M, Pescarmona E, Pileri SA, Carmosino I, Russo E, De Fabritiis P, Alimena G. Clinico-pathological characteristics of myeloid sarcoma at diagnosis and during follow-up: report of 12 cases from a single institution. Leuk Res 2004; 28:1165-69.
9. Yu T, Xu G, Xu X, et al. Myeloid sarcoma derived from the gastrointestinal tract: a case report and review of the literature. Oncol Lett 2016;11:4155-9.
10. Venizelos ID, Frakandreas G, Tatsiou ZA, et al. Isolated myeloid sarcoma of the small intestine in an aleukemic Patient–Case Report and Review of the Literature. Visc Med 2008;24:171–4.
11. Stefanidakis, M., Karjalainen, K., Jaalouk, D.E., Gahmberg, C.G., O’Brien, S., Pasqualini, R. et al. Role of leukemia cell invadosome in extramedullary infiltration. Blood 2009;114: 3008-17.
12. Paydas, S., Zorludemir, S. and Ergin, M. SGranulocytic sarcoma: 32 cases and review of the literature. Leuk Lymphoma 2006;47:2527-41.
13. Yamauchi, K. and Yasuda, M. Comparison in treatments of nonleukemic granulocytic sarcoma: report of 2 cases and a review of 72 cases in the literature. Cancer 94: 1739-46.
14. Avni, B.R., Rund, D., Levin, M., Grisaro, S., Ben-Yehuda, D. and Paltiel, O. Clinical implicationsof acute myeloid leukemia presenting as granulocytic sarcoma. Hematol Oncol, in press. 2011.
Published
2020-07-30
Issue
Section
Case Report
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
