The progression of CD56+ myeloid sarcoma: A case report and literature review

Obstruction of the biliary tract as a rare presentation of acute myeloid leukemia: A case report

To investigate the clinical characteristics of acute myeloid leukemia (AML) with biliary obstruction as the first manifestation and explore the treatment options. A retrospective analysis was performed on a case of AML with biliary obstruction as the first manifestation admitted to the First Affiliated Hospital of Jishou University (Jishou, China). The relevant laboratory examination, imaging, pathological results and treatment strategies were analyzed. The patient was a 44-year-old male with an initial manifestation of biliary obstruction. Combined with the results of laboratory tests and bone marrow aspiration, the patient was diagnosed with AML and was treated with an IA regimen (idarubicin 8 mg d1-3, cytarabine 0.2 d1-5). After 2 courses of treatment, complete response was achieved, the liver function returned to normal and the biliary obstruction disappeared. The initial symptoms of AML are varied, and always combine with multi-system organ damage. Early diagnosis and active treatment of primary diseases are the keys to improving the prognosis of these patients.

Myeloid Sarcomas Causing Unilateral Cranial Nerve Palsies in a Patient with Relapsed Acute Myeloblastic Leukemia

Myeloid sarcomas (MS) are a rare manifestation of myeloid malignancies and can often be misdiagnosed, leading to a delay in treatment. The objective of this clinical case is to highlight the challenges of the clinical presentation and to emphasize the importance of this manifestation ensuring timely diagnosis and therapy. Here, we present a 43-year-old man who was diagnosed with acute myeloblastic leukemia (AML) after being evaluated for unintentional weight loss, subcutaneous nodules, thrombocytopenia, and anemia. The patient underwent chemotherapy with complete remission and presented 4 months later with dysphagia and cranial nerve palsies. Appropriate imaging and biopsy led to a diagnosis of myeloid sarcoma, and a decision was made to begin reinduction chemotherapy for AML achieving a second complete remission although his neurological deficits did not improve. Our case illustrates the protean presentation of myeloid sarcomas; clinicians should have a high suspicion for MS and remain vigilant when unexplained signs and symptoms arise in the background of a myeloid malignancy although challenges still remain when presentation is de novo. Advancements in understanding the pathophysiology of MS have been performed but remain not completely understood. High clinical suspicion, appropriate imaging, biopsy techniques, and expertise are paramount for timely diagnosis and treatment.