title: Post-tonsillectomy pulmonary complication in a patient with tonsillar myeloid sarcoma.
abstract: Myeloid sarcoma in a patient with myelodysplastic syndrome (MDS) manifesting as a non-healing tonsillar ulcer is an extremely rare occurrence. We report the case of a 57-year-old male smoker with a non-healing tonsillar ulcer who underwent tonsillectomy to rule out tonsillar carcinoma after failed antibiotic therapy. On postoperative day 2, he presented with a temperature of 40°C and white blood cell count of 34700/μL. Antibiotic therapy was begun; however, he died 1 day later due to pulmonary infection and septic shock. Though extremely rare, tonsillar involvement of MDS should be considered in the differential diagnosis of a non-healing tonsillar lesion. When definitive diagnosis requires a tissue sample, punch biopsy may be preferable to tonsillectomy in a patient who may be immunocompromised, and appropriate prophylactic antibiotics should be administered.
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Cheng
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Shir-Hwa
authors.initials: SH
authors.lastname: Ueng
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hseuh-Yu
authors.initials: HY
authors.lastname: Li
authors.affiliation: Department of Medical Imaging & Intervention, Chang Gung Memorial Hospital, Taipei, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Huan-Wu
authors.initials: HW
authors.lastname: Chen
authors.affiliation: Taipei Medical University-Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Tsung-Ming
authors.initials: TM
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Li-Ang
authors.initials: LA
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chung-Jan
authors.initials: CJ
authors.lastname: Kang
authors.affiliation: Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Ying-Ling
authors.initials: YL
authors.lastname: Kuo
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hao-Chun
authors.initials: HC
authors.lastname: Huang
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Han-Ren
authors.initials: HR
authors.lastname: Hsiao
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan. d5345@adm.cgmh.org.tw.|College of Medicine, Chang Gung University, Taoyuan, Taiwan. d5345@adm.cgmh.org.tw.|, 5, Fu-Hsing Street, Kuei-Shan, Taoyuan, 33342, Taiwan, R.O.C.. d5345@adm.cgmh.org.tw.
authors.forename: Tuan-Jen
authors.initials: TJ
authors.lastname: Fang
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012141:Respiratory Tract Infections / Q000209:etiology*; D023981:Sarcoma, Myeloid / Q000601:surgery*; D012772:Shock, Septic / Q000209:etiology; D014067:Tonsillar Neoplasms / Q000601:surgery*; D014068:Tonsillectomy / Q000009:adverse effects*