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A perianal presentation of myeloid sarcoma
Navraj S Nagra1, Emilio Lozano2, Elizabeth Soilleux3
1Oxford University Clinical Academic Graduate School, John Radcliffe Hospital, Oxford, UK Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK.
BMJ Case Reports
|May 14, 2015
Summary
This case highlights a rare perianal myeloid sarcoma, a tumor linked to acute myeloid leukemia (AML). Early diagnosis through biopsy is crucial for timely treatment of this aggressive cancer.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Myeloid sarcoma is a rare extramedullary tumor of myeloid blasts.
- It is frequently associated with acute myeloid leukemia (AML) or myelodysplastic/myeloproliferative neoplasms.
- Chronic monomyelocytic leukemia (CMML) can present with myeloid sarcoma, often preceding AML transformation.
Observation:
- A 51-year-old male presented with a perianal mass initially misdiagnosed as hemorrhoids or abscess.
- Initial hematological tests were unremarkable, and the patient was systemically well.
- Histological examination of a biopsy revealed myeloid sarcoma.
Findings:
- Bone marrow aspirate and trephine confirmed a diagnosis of CMML transforming to AML.
- The perianal myeloid sarcoma was indicative of the underlying hematological malignancy.
- The patient's condition required treatment for both the extramedullary tumor and the bone marrow leukemia.
Implications:
- This case underscores the importance of considering rare diagnoses like myeloid sarcoma in perianal lesions.
- Histological examination of biopsies from atypical perianal lesions is critical for early detection.
- Prompt diagnosis and appropriate chemotherapy, such as cytarabine and daunorubicin, are vital for managing myeloid sarcoma associated with AML.
