Acute Megakaryoblastic Leukemia With Myeloid Sarcoma in the Temporal Bone: A Case Report

We report a case of acute megakaryoblastic leukemia (AMKL) with myeloid sarcoma of the temporal bone. The patient was a 14-month-old boy who experienced prolonged bleeding after myringotomy. Endoscopic examination revealed redness and swelling in the left ear. Computed tomography (CT) showed a mastoid cavity filled with soft tissue and bone destruction. Seven days after the first consultation, the patient developed a fever and gait disturbances and was hospitalized. Enhanced CT showed bone destruction of the left ilium and fourth lumbar vertebra, and a tumor lesion around the left ilium. Magnetic resonance imaging demonstrated a tumor extending from the left petrous bone to the cerebellopontine angle. The patient underwent a mastoidectomy and tumor biopsy. Histopathological examination of the tumor revealed a myeloid sarcoma, suggestive of acute myeloid leukemia. The patient was subsequently diagnosed with AMKL. The patient underwent standard multi-agent chemotherapy, followed by allogeneic hematopoietic stem cell transplantation. At the 50-month follow-up, the patient continued to be in remission. In cases with unusual symptoms such as continuous bleeding after myringotomy, temporal bone CT scans should be promptly considered to identify tumors or hematological diseases.