Extramedullary Acute Leukemia-Still an Unforeseen Presentation

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Myeloid sarcomas (MS) are uncommon extramedullary tumors often associated with acute myeloid leukemia (AML).
• MS typically manifest during or after AML diagnosis, rarely preceding it.
• Common sites include lymph nodes, skin, bone, and soft tissues.

Observation:

• A 63-year-old male presented with extramedullary AML at initial diagnosis.
• The leukemia involved the bone marrow, lymph nodes, and skin (leukemia cutis).
• The presentation posed a diagnostic challenge due to atypical sites of involvement.

Findings:

• Diagnosis was confirmed using immunohistochemistry (IHC).
• IHC is vital for diagnosing extramedullary AML, especially in atypical presentations.
• The case underscores the importance of IHC in identifying myeloid sarcomas.

Implications:

• Highlights diagnostic challenges in extramedullary AML.
• Emphasizes the critical role of immunohistochemistry in accurate diagnosis.
• Discusses potential therapeutic options like hypomethylating agents and Venetoclax for non-transplant-eligible patients.