Unusual Presentation of a Granulocytic Sarcoma

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Granulocytic sarcoma is an extramedullary tumor composed of immature granulocytic cells.
• It is an unusual manifestation, often associated with myeloid malignancies.
• Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.

Observation:

• A 76-year-old male with a history of myelodysplastic syndrome presented with symptoms of large bowel obstruction.
• Imaging revealed lesions in the cecum and transverse colon.
• The patient underwent exploratory laparotomy and extended right hemicolectomy.

Findings:

• Pathological examination of the resected colonic lesions confirmed granulocytic sarcoma.
• The tumor was composed of immature granulocytic cells, consistent with extramedullary disease.
• This represented the cause of the patient's large bowel obstruction.

Implications:

• This case underscores the importance of considering granulocytic sarcoma in patients with myelodysplastic syndrome presenting with gastrointestinal obstruction.
• Early diagnosis and appropriate management are crucial for improving outcomes in such rare presentations.
• Further research into the pathogenesis and optimal treatment strategies for extramedullary granulocytic sarcoma is warranted.