Disseminated Nonleukemic Myeloid Sarcoma of the Spleen With Involvement of the Liver in an Infant

A case of primary nonleukemic myeloid sarcoma of the spleen, successfully treated by surgery and hematopoietic stem cell transplantation

Background

Myeloid sarcoma (MS) is a rare disease, mostly found in conjunction with acute myelogenous leukemia or other diseases, and primary nonleukemic MS of the spleen is particularly rare.

Case presentation

We report a 57-year-old male who presented with a spleen mass that was found incidentally, and was enlarged. As a result of various examinations, he was diagnosed with primary MS of the spleen with suspected involvement of the transverse colon, left kidney, pancreatic tail, and left diaphragm. He underwent a total splenectomy, partial pancreatectomy, partial colectomy, left nephrectomy, and left diaphragm partial resection. Histological examination revealed splenic primary MS. Bone marrow biopsy and immunophenotypic flow cytometry revealed no evidence of myeloid leukemia. He underwent umbilical cord blood transplantation, and he is currently living without a sign of recurrence at 10 months after surgery.

Conclusions

We experienced a very rare case of primary spleen MS that was discovered without a hematologic malignancy. Two cases of surgically resected primary splenic MS have been reported, including the present case.

Myeloid sarcoma resulting in a small bowel obstruction with multiple site involvement including ileum and appendix

Myeloid sarcoma (MS) is a rare extra-medullary solid tumor of immature myeloid cells. While it can be an isolated diagnosis, MS is frequently associated with acute myeloid leukemia, chronic myeloid leukemia and myelodysplastic disorders. Although there have been few cases documented that demonstrate the presence of MS in multiple organs at presentation, concomitant involvement of ileum and appendix has never been described. We treated a patient who presented with a small bowel obstruction at the ileum secondary to MS with involvement of the appendix. The patient subsequently underwent a bone marrow biopsy which was negative for evidence of leukemia. He began treatment with induction chemotherapy.