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Granulocytic sarcoma masquerading as Ewing's sarcoma: a diagnostic dilemma
Kunhi Parambath Haresh1, Nikhil Joshi, Chaitali Gupta
1Department of Radiotherapy and Oncology, All India Institute of Medical Sciences, New Delhi-110 029, India. kpharesh@rediffmail.com
Journal of Cancer Research and Therapeutics
|October 17, 2008
Summary
A rare case of acute myeloid leukemia presented as a small round cell tumor in an 11-year-old boy, initially misdiagnosed as Ewing's sarcoma due to MIC2 antigen positivity. This highlights the importance of considering myeloid neoplasms in MIC2-positive round cell tumors.
Area of Science:
- Pediatric Oncology
- Hematology
- Pathology
Background:
- Ewing's sarcoma is a malignant bone tumor typically presenting as a small round blue cell tumor.
- Monoclonal Imperial Cancer research fund 2 (MIC2) antigen is a common marker for Ewing's sarcoma.
Observation:
- An 11-year-old boy presented with elbow swelling, radiologically suspicious for Ewing's sarcoma.
- Histopathology revealed a small round cell tumor positive for MIC2, with bone marrow involvement.
- The patient developed skin lesions identified as chloromas upon biopsy.
Findings:
- Re-evaluation with special stains identified the tumor as granulocytic sarcomas in acute myeloid leukemia.
- The granulocytic sarcoma cells were also positive for MIC2, leading to the initial misdiagnosis.
- This case demonstrates acute myeloid leukemia mimicking Ewing's sarcoma.
Implications:
- The study suggests that myeloid neoplasms should be routinely considered in the differential diagnosis of MIC2-positive small round cell tumors.
- Accurate diagnosis is crucial for appropriate treatment and improved outcomes in pediatric oncology.
- Special stains are vital for differentiating between Ewing's sarcoma and other small round cell tumors.
