[Myeloid sarcoma in uterine leiomyoma]

Area of Science:

• Gynecologic Oncology
• Hematopathology
• Oncology

Background:

• Uterine leiomyomas are common benign tumors.
• Myeloid sarcoma is a rare extramedullary tumor of myeloid blasts.
• Co-occurrence of leiomyoma and myeloid sarcoma is exceptionally rare.

Observation:

• A 44-year-old woman presented with vaginal bleeding and a 4 cm endometrial polyp.
• Histopathology revealed a leiomyoma infiltrated by an undifferentiated neoplasm.
• Immunohistochemistry showed myeloid markers (CD45, MPO, CD68, CD117) and negativity for epithelial, lymphoid, and other mesenchymal markers.

Findings:

• Diagnosis of myeloid sarcoma within a myometrial leiomyoma.
• Subsequent development of acute myeloid leukemia (M5a).
• Patient expired due to complications from therapy-induced immunodeficiency.

Implications:

• Highlights the importance of considering myeloid sarcoma in the differential diagnosis of undifferentiated tumors in extramedullary sites.
• Emphasizes the need for comprehensive immunohistochemical analysis when common markers are negative.
• Underscores the critical role of accurate diagnosis for optimal therapeutic management and patient outcomes.