[Granulocytic sarcoma in a 90-year-old patient]

Area of Science:

• Oncology
• Hematology
• Ophthalmology

Background:

• Granulocytic sarcoma, a rare extramedullary proliferation of immature myeloid cells, is often associated with myelodysplastic syndromes.
• Orbital involvement by granulocytic sarcoma is exceptionally uncommon.
• This condition typically affects patients with pre-existing myeloid malignancies.

Observation:

• A case report detailing granulocytic sarcoma presenting in the orbit, nasal fossae, and ethmoidal sinus.
• The lesion exhibited subperiosteal tumoral infiltration extending to the skin.
• The patient had a history of chronic myelomonocytic leukemia.

Findings:

• The granulocytic sarcoma revealed an acute myeloid leukemia transformation.
• The patient underwent surgical debulking and radiotherapy.
• The patient succumbed to complications of the hematological disease within 3 months.

Implications:

• This case underscores the importance of ophthalmological examination in diagnosing hematological malignancies.
• The occurrence of granulocytic sarcoma during known chronic leukemia, particularly with acute presentation and rapid fatality, is noteworthy.
• Highlights the potential for granulocytic sarcoma to be the initial manifestation of acute myeloid leukemia in patients with underlying myelodysplastic syndromes.