Nonleukemic granulocytic sarcoma in the bile duct: a case report

Area of Science:

• Oncology
• Hematology
• Gastroenterology

Background:

• Granulocytic sarcoma (GS) is an extramedullary tumor of immature myeloid cells, often associated with acute myelogenous leukemia (AML).
• Non-leukemic GS, presenting without overt leukemia or prior history, is exceptionally rare.
• Non-leukemic GS originating in the bile duct is an even more unusual occurrence.

Observation:

• A patient presented with a tumor initially misdiagnosed as a Klatskin tumor (bile duct carcinoma).
• Surgical resection (right lobectomy) was performed based on the initial misdiagnosis.
• Histological examination confirmed the tumor as granulocytic sarcoma, with bone marrow biopsy showing no evidence of leukemia.

Findings:

• The diagnosis of non-leukemic granulocytic sarcoma of the bile duct was established.
• The patient received two cycles of combination chemotherapy, standard for AML treatment.
• The patient remained disease-free for 15 months post-treatment.

Implications:

• This case underscores the importance of considering rare diagnoses like non-leukemic GS, even in the presence of seemingly typical presentations.
• Early diagnosis and appropriate chemotherapy may lead to favorable outcomes in non-leukemic GS, preventing progression to overt leukemia.
• Further research into the pathogenesis and optimal management of non-leukemic extramedullary tumors is warranted.