Irradiation for conjunctival granulocytic sarcoma.
METHODS
A 73-year-old woman with a history of myeloproliferative syndrome (MPS) presented with bilateral chemosis, redness and burning of the eyes. The ocular motility was severely impaired. Ophthalmological examination revealed markedly distended conjunctivas on both sides. Biopsy disclosed conjunctival granulocytic sarcoma as an initial symptom of acute myelogenous leukemia (AML). Diagnosis was confirmed by peripheral blood smear and bone marrow aspiration.


RESULTS
The orbital tumor disappeared completely after local external beam irradiation with a total dose of 30 Gy and no further orbital recurrence occurred. With chemotherapy following irradiation transient hematological remission was achieved. 5 months after diagnosis the patient died of respiratory failure following atypical pneumonia as a consequence of her underlying disorder.


CONCLUSIONS
Detection of orbital granulocytic sarcoma, even in the absence of typical leukemic symptoms is of practical importance, because treatment with irradiation can lead to stabilization or improvement in the patient's vision.
Fleckenstein
Katharina
K
Department of Radiation Oncology, Technical University of Munich, Germany. kflecken@gmx.de
Geinitz
Hans
H
Grosu
Anca
A
Goetze
Katharina
K
Werner
Martin
M
Molls
Michael
M
D000368:Aged; D001706:Biopsy; D003228:Conjunctiva / Q000473:pathology; D003230:Conjunctival Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D011879:Radiotherapy Dosage