Granulocytic sarcomas of the head and neck

Granulocytic sarcomas (chloromas) are rare tumors with a predilection for head and neck sites. In a review of six cases from two teaching institutions, chloromas were associated with the development of acute myelogenous leukemia or a relapse in five cases. Treatment modalities included chemotherapy and radiation therapy for problematic lesions. Our only survivor received combination therapy despite a negative bone marrow examination. Work-up should include a computed tomographic scan or magnetic resonance imaging to evaluate the extent of the tumor. Bone marrow examination and biopsy should be performed and specimens prepared for immunohistochemical studies or electron microscopy. Recommended treatment includes both aggressive chemotherapy and 2000 to 3000 cGy of external-beam radiotherapy to the tumor when possible.