title: Cutaneous myeloid sarcoma: natural history and biology of an uncommon manifestation of acute myeloid leukemia.
abstract: We conducted a retrospective study of patients with cutaneous myeloid sarcoma, from 2 tertiary care institutions. Eighty-three patients presented, with a mean age of 52 years. Diagnosis of myeloid sarcoma in the skin was difficult due to the low frequency of myeloperoxidase and/or CD34+ cases (56% and 19% of tested cases, respectively). Seventy-one of the 83 patients (86%) had ≥ 1 bone marrow biopsy. Twenty-eight (39%) had acute myeloid leukemia with monocytic differentiation. Twenty-three had other de novo acute myeloid leukemia subtypes. Thirteen patients had other myeloid neoplasms, of which 4 ultimately progressed to an acute myeloid leukemia. Seven had no bone marrow malignancy. Ninety-eight percent of the patients received chemotherapy, and approximately 89% died of causes related to their disease. Cutaneous myeloid sarcoma in most cases represents an aggressive manifestation of acute myeloid leukemia. Diagnosis can be challenging due to lack of myeloblast-associated antigen expression in many cases, and difficulty in distinguishing monocyte-lineage blasts from neoplastic and non-neoplastic mature monocytes.
authors.affiliation: Department of Dermatology, Saint Louis University, St. Louis, MO 63104, USA.
authors.forename: M Yadira
authors.initials: MY
authors.lastname: Hurley
authors.forename: Grant K
authors.initials: GK
authors.lastname: Ghahramani
authors.forename: Stephanie
authors.initials: S
authors.lastname: Frisch
authors.forename: Eric S
authors.initials: ES
authors.lastname: Armbrecht
authors.forename: Anne C
authors.initials: AC
authors.lastname: Lind
authors.forename: Tudung T
authors.initials: TT
authors.lastname: Nguyen
authors.forename: Anjum
authors.initials: A
authors.lastname: Hassan
authors.forename: Friederike H
authors.initials: FH
authors.lastname: Kreisel
authors.forename: John L
authors.initials: JL
authors.lastname: Frater
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D001856:Bone Marrow Examination; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008923:Missouri; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D023981:Sarcoma, Myeloid / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000401:mortality / Q000473:pathology; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000401:mortality / Q000473:pathology; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents