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A Lateral Neck Myeloid Sarcoma Presenting as Acute Otitis Externa.

Rambod Mozafari1, Kamran Alimoghaddam1, Hamed Sotoude2

  • 1Department of Hematology, Oncology, and Bone Marrow Transplantation, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

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Myeloid sarcoma (MS) can present as an isolated extramedullary relapse after acute myeloid leukemia treatment. Early diagnosis and combined therapies are crucial for better survival in these rare cases.

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Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Myeloid sarcoma (MS) is an extramedullary tumor of myeloid cells, often associated with acute leukemia.
  • Diagnosis requires pathological and immunohistochemical evaluation due to varied presentations.
  • Isolated extramedullary relapse (iEMR) after allogeneic stem cell transplantation (allo-SCT) is rare and may not involve bone marrow.

Observation:

  • This case report details a patient with a history of acute myeloid leukemia (AML) who underwent allo-SCT.
  • The patient presented with a left lateral neck mass mimicking acute otitis externa.
  • The mass was diagnosed as an isolated myeloid sarcoma.

Findings:

  • Myeloid sarcoma can occur as an isolated extramedullary relapse post-allo-SCT, independent of bone marrow involvement.
  • Leukemic cells can persist in extramedullary sites despite systemic therapy and graft-versus-leukemia effects.
  • Accurate diagnosis relies on pathology and immunohistochemistry.

Implications:

  • MS should be considered in patients with a history of acute leukemia, even with infectious-like symptoms.
  • Timely diagnosis of iEMR is critical for patient survival.
  • Combined therapeutic strategies (systemic, local, cellular) are recommended for managing iEMR post-allo-SCT.