Laparoscopic management of an obstructing granulocytic sarcoma of the jejunum causing intussusception in a nonleukemic patient: report of a case.
Granulocytic sarcoma is an extramedullary tumor of immature myeloid cells which is often a forerunner to the development of acute myelogenous leukemia. Granulocytic sarcoma of the gastrointestinal tract frequently involves the small intestine and often presents with abdominal pain and obstruction. Our patient presented with a proximal jejunal mass causing intussusception and obstruction. This type of manifestation has never before been reported. A laparoscopy-assisted resection of the affected portion of jejunum was performed for him. The initial pathological findings were high-grade non-Hodgkin's lymphoma; immunohistochemistry confirmed a diagnosis of granulocytic sarcoma. After a follow-up of 14 months, there was no evidence of leukemia. This condition is often mistaken for lymphoma and confirmation is necessary by immunohistochemistry. Chemotherapy is the treatment of choice and surgery is indicated only in the event of complications, such as bowel obstruction, bleeding, or perforation. The prognosis of granulocytic sarcoma is similar to that of myeloid leukemia.
Palanivelu
Chinnusamy
C
GEM Hospital & Postgraduate Institute, 45-A Pankaja Mill Road, Ramnathapuram, Coimbatore, 641045, India.
Rangarajan
Muthukumaran
M
Senthilkumar
Ramakrishnan
R
Annapoorni
Shankar
S
D006801:Humans; D007443:Intussusception / Q000209:etiology / Q000601:surgery*; D007580:Jejunal Neoplasms / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D023981:Sarcoma, Myeloid / Q000150:complications / Q000601:surgery*