title: Ovarian granulocytic sarcoma as the primary manifestation of acute myelogenous leukemia.
abstract: Granulocytic sarcoma (GS) usually occurs concomitantly with or after the onset of acute myeloid leukemia (AML) or other myeloproliferative disorders, however, GS of the ovary as the primary manifestation of AML is exceedingly rare. To the best of our knowledge, eight cases of ovarian GS as the first sign of AML have been reported in the literature. Here, we report the ninth case: a 27-year-old female who presented with an ovarian mass without any underlying hematologic disorder. A high index of suspicion aided by immunohistochemistry established the correct diagnosis of undifferentiated GS that involved the ovary. Simultaneously, laboratory findings indicated that the blood counts continually increased after surgery. Five days after the surgery, bone marrow biopsy confirmed the presence of AML. After establishing the diagnosis, the patient was sent to the hematology department to receive cytosine arabinoside and idarubicin chemotherapy. This report outlines an exceedingly rare case of AML that initially manifested as an ovarian GS. Awareness of this entity will enable earlier diagnosis and appropriate treatment.
authors.affiliation: Department of Pathology, Shanghai Gongli Hospital Shanghai, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ding
authors.affiliation: Department of Pathology, Hua Bei Oil Field Total Hospital Hebei, People's Republic of China.
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Pathology, Shanghai Gongli Hospital Shanghai, People's Republic of China.
authors.forename: Yu-Kai
authors.initials: YK
authors.lastname: Qi
authors.affiliation: Department of Pathology, Shanghai Gongli Hospital Shanghai, People's Republic of China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Pathology, Fudan University Shanghai Cancer Center Shanghai, People's Republic of China.
authors.forename: Ze-Bin
authors.initials: ZB
authors.lastname: Liu
authors.affiliation: Department of Radiology, Shanghai Gongli Hospital Shanghai, People's Republic of China.
authors.forename: Bin-Cang
authors.initials: BC
authors.lastname: Huang
authors.affiliation: Department of Pathology, Shanghai Gongli Hospital Shanghai, People's Republic of China.
authors.forename: Wei-Xiang
authors.initials: WX
authors.lastname: Chen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000209:etiology* / Q000473:pathology; D023981:Sarcoma, Myeloid / Q000209:etiology* / Q000473:pathology
keywords: Ovary neoplasm; acute myelogenous leukemia; chloroma; granulocytic sarcoma