[Acute promyelocytic leukemia accompanied by scrotal Fournier's gangrene during ATRA treatment and relapsed as external ear tumor].
A 43-year-old man was admitted because of gingival bleeding. A diagnosis of acute promyelocytic leukemia (APL) was made. He was given combination chemotherapy including all-trans retinoic acid (ATRA). During the myelosuppression stage, the patient developed Fournier's gangrene of the scrotum. He achieved complete remission and underwent a hemicastration procedure. Seven months later, bilateral external ear tumors developed. Biopsy specimens of the tumors revealed infiltration of APL cells. A second remission was obtained by chemotherapy including ATRA. However, bilateral ear tumors developed again 5 months later despite indications of normal marrow without proliferation of leukemic blasts. Irradiation successfully reduced the ear tumors, but the patient died of cerebral hemorrhage from a left frontal extramedullary tumor. This was a rare case of APL accompanied by Fournier's gangrene of the scrotum during ATRA treatment, and by extramedullary tumors of the external ear and brain during leukemic relapse.
Goto
H
H
First Department of Internal Medicine, Gifu University School of Medicine.
Tsurumi
H
H
Kasahara
S
S
Hara
T
T
Yamada
T
T
Sawada
M
M
Tanabashi
S
S
Kametani
M
M
Moriwaki
H
H
D000328:Adult; D004428:Ear Neoplasms / Q000209:etiology* / Q000473:pathology; D018934:Fournier Gangrene / Q000209:etiology*; D005832:Genital Diseases, Male / Q000209:etiology; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000473:pathology; D012611:Scrotum; D014212:Tretinoin / Q000008:administration & dosage / Q000009:adverse effects*
D014212:Tretinoin