Chloroma of the forearm: a case report of leukemia recurrence presenting with compression neuropathy and tenosynovitis.
Acute Myelogenous Leukemia (AML) typically involves intramedullary proliferation of myeloid precursor cells. Extramedullary manifestations of AML are exceedingly rare, but do occur. Granu-locytic sarcoma, or chloroma, is one example of extramedullary leukemia cells forming a tumorous mass. We report a case of Chloroma in the volar forearm compartment presenting with both median nerve compressive neuropathy and apparent tenosynovitis. Abscess was at the top of the early differential, and the patient was scheduled for operative debridement. However, further evaluation indicated that chloroma was present, thus obviating the need for emergent surgical intervention and necessitating the induction of chemotherapy. To our knowledge this is the first report of chloroma in this location and with these presenting symptoms.
Warme
Bryan
B
Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Sullivan
Jaron
J
Tigrani
Dean-Yar
DY
Fred
Dietz M D
DM
D000971:Antineoplastic Combined Chemotherapy Protocols; D002648:Child; D005260:Female; D005542:Forearm; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy; D009408:Nerve Compression Syndromes / Q000175:diagnosis* / Q000209:etiology; D012008:Recurrence; D023981:Sarcoma, Myeloid / Q000150:complications / Q000175:diagnosis* / Q000209:etiology*; D013717:Tenosynovitis / Q000175:diagnosis* / Q000209:etiology