title: Isolated Uterine Myeloid Sarcoma Preceding the Diagnosis of Acute Myeloid Leukemia.
abstract: Myeloid sarcoma (MS) is an extramedullary solid tumor composed of leukemic myeloid cells. MS is an uncommon tumor complicating acute myeloid leukemia (AML), or less often myelodysplestic syndrome (MDS) and myeloproliferative disorders. Rarely, MS may precede the systemic onset of AML, which usually follows within months. We report a 36 year-old lady who presented with a cervical-uterine mass, which proved to be MS. Initially, she had no systemic AMLand was treated with hysterectomy and systemic chemotherapy. She developed bilateral-flank pain and renal impairment after 9 months. Imaging revealed a soft-tissue mass in the para-aortic and peri-sacral region with bilateral hydronephrosis. Biopsy from the mass confirmed recurrence of MS. Bone marrow (BM) biopsy revealed 20% blasts consistent with AML. She was treated with aggressive chemotherapy and local radiotherapy. Despite these measures, she died of progressive disease. MS should be considered and treated as systemic AML, rather than an isolated mass; and we discuss management issues in such patients.
authors.affiliation: Department of Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Aamer
authors.initials: A
authors.lastname: Aleem
authors.affiliation: Department of Division Hematology - Oncology, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Shahid
authors.initials: S
authors.lastname: Aziz
authors.affiliation: Department of Emergency Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Sajjad
authors.initials: S
authors.lastname: Hussain
authors.affiliation: Department of Radiology and Pathology, Division of Hematopathology,College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Fatmah
authors.initials: F
authors.lastname: Algahtani
authors.affiliation: Department of Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Alsaleh
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000473:pathology* / Q000601:surgery; D023981:Sarcoma, Myeloid / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014599:Uterus / Q000473:pathology