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CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Post-tonsillectomy pulmonary complication in a patient with tonsillar myeloid sarcoma
Chia-Chi Cheng1,2, Shir-Hwa Ueng3,2, Hseuh-Yu Li1,2
1Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.
International Journal of Hematology
|January 15, 2011
Summary
Myeloid sarcoma, a rare complication of myelodysplastic syndrome (MDS), can present as a tonsillar ulcer. Early diagnosis and biopsy are crucial for immunocompromised patients with non-healing throat lesions.
Area of Science:
- Oncology
- Hematology
Background:
- Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.
- Myeloid sarcoma (MS) is an extramedullary tumor of myeloid blasts, often associated with myeloid neoplasms.
- Tonsillar involvement by MS in MDS patients is exceptionally rare.
Observation:
- A 57-year-old male smoker presented with a non-healing tonsillar ulcer.
- Initial treatment with antibiotics failed, leading to tonsillectomy to exclude malignancy.
- Postoperatively, the patient developed fever and leukocytosis, progressing to septic shock and death.
Findings:
- The patient's presentation was ultimately attributed to myeloid sarcoma of the tonsil secondary to myelodysplastic syndrome.
- The rapid deterioration and fatal outcome highlight the aggressive nature of this rare manifestation.
- Autopsy revealed pulmonary infection and septic shock as the terminal events.
Implications:
- Tonsillar MS should be considered in the differential diagnosis of non-healing tonsillar lesions, especially in patients with MDS.
- Punch biopsy may be a safer diagnostic approach than tonsillectomy in potentially immunocompromised patients.
- Prophylactic antibiotics are recommended for immunocompromised patients undergoing procedures for undiagnosed lesions.
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