Myeloid sarcoma is a rare disease, where a mass (tumor) of either myeloblasts or immature myeloid cells conglomerate in extramedullary anatomic sites. It may arise de-novo or it may present in association with acute myeloid leukemia. It can also occur in patients with myelodysplastic syndromes, myeloproliferative disorders, and blast transformation in myeloproliferative neoplasia. Myeloid sarcoma of the head and neck area can pose a diagnostic challenge because of the low frequency of occurrence, and the vast diversity of tumors occurring from multiple lineages in this anatomic region. This can lead to a broad spectrum of various differential diagnoses. Therefore, a high index of suspicion is required when dealing with a possible case of myeloid sarcoma, as it is a time-sensitive diagnosis with various diagnostic dilemmas. Here, we report an example, a case of tonsillar myeloid sarcoma. We wish to highlight the investigations that helped us procure this diagnosis in a timely manner.
Alexiev BA, Wang W, Ning Y, Chumsri S, Gojo I, Rodgers WH, et al. Myeloid sarcomas: a histologic, immunohistochemical, and cytogenetic study. Diagn Pathol. 2007 Oct 31; 2:42. https://doi.org/10.1186/1746-1596-2-42
Papamanthos MK, Kolokotronis AE, Skulakis, HE, Fericean AM, Zorba MT, Matiakis AT. Acute myeloid leukaemia diagnosed by intra-oral myeloid sarcoma. A case report. Head Neck Pathol. 2010 Jun; 4(2):132-5. https://doi.org/10.1007/s12105-010-0163-9
Kaygusuz G, Kankaya D, Ekinci C, Topçuoğlu P, Kuzu I. Myeloid sarcomas: a clinicopathologic study of 20 cases. Turk J Hematol. 2015 Mar 5.32(1):35-42. https://doi.org/10.4274/tjh.2013.0087
Payne C, Olivero WC, Wang B, Moon SJ, Farahvar A, Chen E, et al. Myeloid sarcoma: a rare case of an orbital mass mimicking orbital pseudotumor requiring neurosurgical intervention. Case Rep Neurol Med. 2014; 2014: 395196. https://doi.org/10.1155/2014/395196
Zhou J, Bell D, Medeiros LJ. Myeloid sarcoma of the head and neck region. Arch Pathol Lab Med. 2013 Nov;137(11):1560-8.https://doi.org/10.5858/arpa.2012-0537-oa
Krause JR. Granulocytic sarcoma preceding acute leukemia : a report of six cases Cancer. 1979 Sep; 44(3).1017-21. https://doi.org/10.1002/1097-0142(197909)44:3%3C1017::aid-cncr2820440333%3E3.0.co;2-i
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2017 Madhusudhan Krishnamoorthy et al.