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Updated: Oct 6, 2025
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Published on: July 21, 2023
[A Case of Myeloid Sarcoma in the Small Intestine Presenting with Intussusception]
Tomohiko Machida1, Katsufumi Miyamoto, Tatsuro Ooishi
1Dept. of Surgery, Hyogo Prefectural Awaji Medical Center.
Insights
A sixty-something man was diagnosed with acute myeloid leukemia M2, presenting with myeloid sarcoma in the intestine and hip. This case highlights intestinal intussusception as a rare presentation of acute myeloid leukemia.
Area of Science:
- Hematology
- Oncology
- Gastroenterology
Background:
- Acute myeloid leukemia (AML) can manifest with extramedullary disease, a condition where leukemia cells grow outside the bone marrow.
- Myeloid sarcoma, a tumor of immature myeloid cells, is a known extramedullary manifestation of AML.
- Intestinal intussusception is a rare but serious complication, often associated with underlying malignancy.
Observation:
- A sixty-something male presented with lower abdominal pain and was found to have a soft tissue mass near the left hip and enlarged lymph nodes.
- Abdominal CT revealed a small-intestinal intussusception and suspected malignant lymphoma.
- A CT-guided biopsy of the hip mass and surgical resection of the intussusception were performed.
Findings:
- Pathological diagnosis confirmed myeloid sarcoma in both the hip mass and the resected ileal intussusception.
- Bone marrow biopsy revealed acute myeloid leukemia M2.
- The patient achieved remission after induction and consolidation therapy.
Implications:
- This case underscores the importance of considering myeloid sarcoma, particularly presenting as intestinal intussusception, as a rare subtype of acute myeloid leukemia.
- Early recognition and diagnosis of extramedullary AML manifestations are crucial for timely and effective treatment.
- Intestinal intussusception in adults warrants thorough investigation for underlying malignancy, including rare hematological disorders.
Abstract:
A sixty-something man presented with lower abdominal pain in early Y month 20XX, and was examined at the hospital's internal medicine outpatient clinic. An abdominal CT showed a soft tissue mass around the left hip joint, and multiple enlarged lymph nodes from inside the pelvis to the mesentery of the abdomen. We noted a small-intestinal intussusception in the lower right abdomen, and suspected malignant lymphoma. We did a CT-guided biopsy on the left hip joint soft tissue mass, and performed surgery on the small-intestinal intussusception. During surgery, we noted an approximately 30 cm ileal intussusception located about 60 cm from the terminal ileum, and enlarged lymph nodes in the nearby mesentery. We removed the ileal intussusception. The pathological diagnosis was myeloid sarcoma, and the soft tissue mass in the left hip joint was also diagnosed as myeloid sarcoma. We performed a bone-marrow biopsy at the hematology department, and diagnosed acute myeloid leukemia M2. We then started remission-induction therapy and consolidation therapy, and the patient was diagnosed as in remission in Y+5 month 20XX. We also need to keep in mind myeloid sarcoma in the intestine as a subtype of acute myeloid leukemia, as malignant tumor in the small intestine presenting with intussusception.
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