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Gastrointestinal Myeloid Sarcoma a Case Presentation and Review of the Literature. Mediterr J Hematol Infect Dis 2021; 13:e2021067. [PMID: 34804441 PMCID: PMC8577557 DOI: 10.4084/mjhid.2021.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/19/2021] [Indexed: 11/08/2022] Open
Abstract
Myeloid sarcomas can be detected in up to 30% of acute myeloid leukemia cases or occur de-novo without bone marrow involvement. The most frequent localization of myeloid sarcomas in the abdominal cavity is the small intestine, and gastric presentations are infrequent, frequently misdiagnosed, and a high level of suspicion should exist when the characteristic histomorphology features are present. The current review features a case report with gastric presentation of myeloid sarcoma in a patient with a diagnosis of acute myeloid leukemia with trisomy 8. In addition, a review of the literature of intestinal-type myeloid sarcomas shows that less than 15% of these cases have been reported in the stomach. The most common molecular aberrancy detected in intestinal myeloid sarcomas is the fusion protein CBFB-MYH11. A review of several large studies demonstrates that the presence of myeloid sarcoma does not constitute an independent prognostic factor. The therapeutic approach will be tailored to the specific genetic abnormalities present, and systemic chemotherapy with hematopoietic stem cell transplant is the most efficient strategy.
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Mizumoto R, Tsujie M, Wakasa T, Kitani K, Manabe H, Fukuda S, Okada K, Satoi S, Ishikawa H, Kawasaki T, Hanamoto H, Yukawa M, Inoue M. Isolated myeloid sarcoma presenting with small bowel obstruction: a case report. Surg Case Rep 2020; 6:2. [PMID: 31900687 PMCID: PMC6942080 DOI: 10.1186/s40792-019-0759-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/06/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Myeloid sarcoma (MS) is a solid tumor consisting of myeloid blasts or immature myeloid cells, which are unusual outside the bone marrow. CASE PRESENTATION We present a rare case of isolated myeloid sarcoma of the small bowel in a 54-year-old man who was admitted to our hospital with repeated symptoms of intestinal obstruction. A small bowel series via an ileus tube revealed severe jejunal obstruction. Computed tomography revealed that the obstruction was likely caused by a jejunal tumor. The patient underwent laparoscopy-assisted partial resection of the jejunum with lymphadenectomy. Histopathological examination of the surgical specimen confirmed that MS had been responsible for the obstruction. CONCLUSIONS Patients with MS require systemic chemotherapy, as do patients with acute myeloid leukemia. Hence, an early, accurate diagnosis is imperative for treating this malignancy. It is also important to list MS in the differential diagnosis of a small bowel tumor, even in nonleukemic patients.
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Affiliation(s)
- Rie Mizumoto
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Masanori Tsujie
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Tomoko Wakasa
- Department of Pathology and Laboratory Medicine, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Kotaro Kitani
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Hironobu Manabe
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Shuichi Fukuda
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Kaoru Okada
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Shumpei Satoi
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Hajime Ishikawa
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Toshihiko Kawasaki
- Department of Gastroenterology and Hepatology, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Hitoshi Hanamoto
- Department of Hematology, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
| | - Masao Yukawa
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan.
| | - Masatoshi Inoue
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda, Ikoma, Nara, 630-0293, Japan
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