Isolated myeloid sarcoma of the tibia
Myeloid sarcoma is a rare tumor of immature myeloid cells in an extramedullary site which can be found in any part of the body. It may precede or concurrently occur with acute myeloid leukemia, chronic myeloid leukemia, or myeloproliferative disorders/myelodysplastic syndrome.
Herein is reported the rare case of a child with myeloid sarcoma in the right tibia, without leukemic involvement at diagnosis. Diagnosis was challenging and several imaging modalities (radiography, computed tomography, magnetic resonance, bone scintigraphy, positron emitted tomography–computed tomography) were required. Additionally, three biopsies were necessary to make a definitive and conclusive diagnosis.
With this case report, the authors intend to emphasize the need of considering myeloid sarcoma in the differential diagnosis of lytic bone lesions in children and highlight the high degree of clinical suspicion required when there is no leukemia evidence.
Swerdlow SH. Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. WHO classification of tumours of haematopoietic and lymphoid tissues, fourth edition. Lyon: IARC. 2008:140-1.
Samborska M, Derwich K, Skalska-Sadowska J, Kurzawa P, Wachowiak J. Myeloid sarcoma in children - diagnostic and therapeutic difficulties. Contem Oncol . 2016; 20:444-8.
Pui MH, Fletcher BD, Langston JW. Granulocytic Sarcoma in Childhood Leukemia: Imaging Features. Radiology. 1994; 190:698-702.
Guermazi A, Feger C, Rousselot P, Merad M, Benchaib N, Bourrier P. Granulocytic Sarcoma (Chloroma): Imaging Findings in Adults and Children. AJR. 2002; 178:319-25.
Ingale Y, Patil T, Chaudhari P, Routray S, Agrawal M. Granulocytic Sarcoma of Parotid Gland in a 4-Year-Old Child with Subleukemic AML: A Diagnostic Challenge! Case Rep Otolaryngol. 2013; 2013:321289.
Gupta AJ, Mandal S, Gupta R, Khurana N, Gulati A. Myeloid Sarcoma Presenting as Nasal and Orbital Mass: An Initial Manifestation od an Acute Myeloid Leukaemia. J Clin Diagn Res. 2017; 11:ED24–6.
Bain EE, Rothman I, Lin L. De novo myeloid sarcoma in a 4-month-old infant: a case report and review of the literature. J Cutan Pathol . 2013; 40:321-25.
Sharma A, Singh HP, Gupta AA, Garg P, Moon NJ, Chavan R. Granulocytic sarcoma in non-leukaemic child involving maxillary sinus with long term follow up: A rare case report. Ann Maxillofac Surg. 2014; 4: 90-5.
Sengupta M, Das I, Chatterjee U, Majumdar B. De novo myeloid sarcoma involving mandible in a child: Report of a rare occurrence. J Oral Maxillofac Pathol. 2016; 20:304-7.
Shiozawa Y, Kiyokawa N, Saito M, Fujimoto J, Hata JI, Yamashiro Y. Granulocytic sarcoma of the spine in a child without bone marrow involvement: a case report and literature review . Eur J Pediatr. 2005; 164:616-20.
Rénard C, Girard S, Pracros JP, Dijoud F, André JM, Mialou V, et al. La sarcome granulocytaire, un diagnostic à connaître: à propos de 3 observations pédiatriques. Archives de Pédiatrie. 2010; 17:149-53.
Krause, J. Granulocytic sarcoma preceding acute leukemia. Cancer . 1979; 44:1017-21.
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