Isolated Myeloid Sarcoma: A Diagnostic Dilemma

Abstract

Myeloid sarcoma (MS)/granulocytic sarcoma/myeloblastoma/chloroma is a rare extramedullary proliferation of blast cells of one or more myeloid lineages along with the destruction of the normal architecture of adjacent tissue. Isolated MS is a rare entity with an incidence of 0.7 out of 1 million children and 2 out of 1 million adults. Varied clinical presentation, the rarity of the diagnosis, inadequate immunophenotyping, and lack of available literature makes the disease difficult to manage. Here, we report a case of MS in a 44-year-old male with an initial presentation of testicular mass without bone marrow involvement, causing diagnostic challenges. In this case report, we discuss the pathogenesis, diagnostic challenges, and therapeutic options of MS.

Keywords: acute myeloid sarcoma; aml; cytarabine; leptomeninges; testicular mass.

Figure 1. PET-CT, status post-bilateral orchiectomy, revealing an 8.0 SUV focus of hypermetabolic activity in the right hemiscrotum concerning for locally recurrent disease.

PET-CT: positron emission tomography-computed tomography; SUV: standardized uptake value

Figure 2. MRI of the spine showing a very large, heterogeneously enhancing, mixed-signal, mass-like lesion in the left hemipelvis.

MRI: magnetic resonance imaging