Sun X, Rong X, Nie H, Yan X. Isolated retro-orbital granulocytic sarcoma relapse of Acute Myeloid Leukemia after allogeneic hematopoietic stem cell transplantation: a case report.
Eur J Ophthalmol 2020;
32:1120672120976551. [PMID:
33283547 DOI:
10.1177/1120672120976551]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND
Granulocytic sarcoma (GS) is rare as an isolated presentation of relapse after allogeneic hematopoietic stem-cell transplantation (allo-HSCT), particularly in adult patients with acute myelogenous leukemia (AML). We report here the case of a 37-year-old man who developed a GS of the retro-orbital as an isolated manifestation of AML relapse 27 months after allo-HSCT.
CASE REPORT
A 37-year-old man was diagnosed with AML and subsequently received allo-HSCT after clinical chemical remission. The patient suddenly presented with painless exophthalmos of the left eye twenty-seven months after allo-HSCT. Orbital magnetic resonance imaging (MRI) revealed left retro-orbital masses. Histopathology revealed diffused infiltration of leukemic blasts. Further systemic investigation showed no leukemic involvement of his other organs. Isolated retro-orbital relapse of AML was diagnosed. Despite treatment using retro-orbital irradiation, the patient died 6 months after presentation.
CONCLUSION
Our patient had a poor survival prognosis, even with timely diagnosis and proper treatment. Although the ophthalmologist has a secondary role in the diagnosis and treatment of leukemia, a prompt recognition of the ocular manifestations and their significance as a sign of possible extramedullary lesion is crucial.
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