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Primary Vaginal Chloroma: A Rare Case Report.
Irappa Madabhavi1, Apurva Patel2, Mitul Modi3
1Department of Medical and Paediatric Oncology, Kerudi Cancer Hospital, Bagalkot, Karnataka, India.
This case study highlights a rare instance of chloroma, a myeloid sarcoma, presenting initially as vaginal bleeding in a 38-year-old female. The patient received successful chemotherapy, demonstrating a rare presentation of this extra-medullary neoplasm.
Area of Science:
- Oncology
- Hematology
Background:
- Chloroma, also known as granulocytic sarcoma or myeloid sarcoma, is a rare malignant extra-medullary neoplasm.
- It typically arises in association with myeloproliferative disorders but can uncommonly precede acute myeloid leukemia (AML).
Observation:
- A 38-year-old female presented with vaginal bleeding, initially diagnosed via biopsy.
- Biopsy revealed leukocyte common antigen (LCA), myeloperoxidase (MPO), and c-kit positivity via immunohistochemistry (IHC), with negativity for cytokeratin, synaptophysin, chromogranin, and CD20.
- A whole-body CT scan identified a vaginal mass lesion.
Findings:
- The patient was diagnosed with chloroma without an initial presentation of AML.
- Immunohistochemistry confirmed myeloid precursor cell origin.
Implications:
- This case underscores the importance of considering rare presentations of myeloid sarcoma, even without overt signs of leukemia.
- Successful treatment with standard induction and consolidation chemotherapy (3+7 regimen followed by high-dose cytarabine) was achieved.
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