Myeloid sarcoma in a one-month-old infant

Area of Science:

• Hematology
• Pediatric Oncology
• Dermatology

Background:

• Myeloid sarcoma is a rare extramedullary tumor of myeloid blasts.
• It can be associated with systemic leukemia or occur in isolation.
• Congenital myeloid sarcoma is exceptionally rare, particularly without overt signs of leukemia.

Observation:

• A 1-month-old infant presented with a bruise-like skin plaque.
• Histopathology revealed atypical large lymphocytes (CD4+, CD56-, CD68+) in the dermis and subcutaneous tissue.
• Bone marrow biopsy showed minimal blast cells (3.4%) with mixed-lineage leukemia gene abnormality.

Findings:

• The infant was diagnosed with myeloid sarcoma not meeting criteria for systemic leukemia.
• Skin lesions resolved within 10 days of chemotherapy.
• No recurrence was observed for 1.5 years post-treatment.

Implications:

• This case highlights congenital myeloid sarcoma as a distinct entity presenting primarily with cutaneous manifestations.
• Early diagnosis and treatment can lead to favorable outcomes, even in the absence of systemic leukemia.
• Further research into the unique biology and treatment of isolated congenital myeloid sarcoma is warranted.