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Leukemic dermal infiltrate at the exit site of a central venous catheter
R Martino1, A Sureda, D Sitjas
1Department of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Insights
This case report details a rare instance of skin relapse in minimally differentiated acute myeloid leukemia (FAB M0). This cutaneous leukemic infiltration occurred at a catheter site during remission, preceding bone marrow relapse.
Area of Science:
- Hematology
- Oncology
- Dermatology
Background:
- Minimally differentiated acute myeloid leukemia (FAB M0) is a rare subtype.
- Cutaneous involvement in acute myeloid leukemia is uncommon, particularly during remission.
Observation:
- A 55-year-old woman with FAB M0 developed a subcutaneous nodule at a Hickman catheter scar site during chemotherapy-induced remission.
- Biopsy of the nodule confirmed leukemic infiltration of the dermis and hypodermis.
Findings:
- The patient experienced bone marrow relapse three weeks after the cutaneous manifestation.
- This suggests a potential pattern of extramedullary relapse at sites of previous intervention.
Implications:
- Highlights the importance of recognizing cutaneous leukemic relapse, even in remission.
- Suggests vigilance for extramedullary disease in acute myeloid leukemia patients, especially at catheter sites.
- Warrants further investigation into the mechanisms and clinical significance of such relapses.
Abstract:
This report describes the case of a minimally differentiated acute myeloid leukemia (FAB M0) diagnosed in a 55-year-old woman. During a second chemotherapy-induced complete remission, a subcutaneous nodule appeared at the scar of a recently removed Hickman catheter, which when biopsied revealed leukemic infiltration of the dermis and hypodermis. The patient had a bone marrow relapse three weeks later. The authors review similar recent reports and emphasize the importance of recognizing this particular type of cutaneous leukemic relapse.