A Rare Case of Myeloid Sarcoma Presenting as an Anorectal Ulcer

Abstract

Myeloid Sarcoma is a rare tumor composed of myeloblasts occurring at an extramedullary site like bones, or various soft tissues. Myeloid sarcoma may involve the gastrointestinal tract very rarely either solitarily, or occurring simultaneously with acute myeloid leukemia. Its diagnosis is challenging and needs biopsy and immunohistochemical staining. We are describing a case of myeloid sarcoma which presented as a painful anal ulcer mimicking an atypical fissure. Its appearance resembled crohn's disease on sigmoidoscopy. A biopsy of the ulcer along with histochemical staining led to the diagnosis of myeloid sarcoma. Our case demonstrates the need for aggressive evaluation of any common gastrointestinal complaint with an atypical presentation.

Does lower gastrointestinal endoscopy during pregnancy pose a risk for mother and child? – a systematic review

“… Etiological relation with endoscopy? Sigmoidoscopy IBD & colitis other [ 11 - 16 ] 6 None Live birth (n = 6) No (n = 6) 3 premature births (34, 28 and 25.5 wks) No No Malignancy [ 17 , 18 ] 3 (in 2 pts) None Elective abortion (n = 2) No (n = 2) Elective abortion (unwanted pregnancies) Yes (n = 2) No Volvulus and incarcerated uterus [ 19 ] 1 None No pregnancy losses No (n = 1) Not reported No No Non-malignant colonic obstruction 0 - - - - - - Gastrointestinal bleeding [ 20 ] 1 None Incomplete abortion (n = 1) Yes, incomplete abortion at 10.4 wks (n = 1) - Yes Possible, abdominal pregnancy, laparotomy after sigmoidoscopy Colonoscopy IBD & colitis other [ 21 - 27 ] 12 None Live births (n = 11), stillbirth (n = 1) No (n = 12) 2 premature births (32 and 33 wks), 1 stillbirth (22 wks) Unclear, paper fails to show which outcome belongs to which patient No, authors do not link adverse events to endoscopy Malignancy [ 28 - 32 ] 5 Maternal death (n = 1), none (n = 4) Live birth (n = 5) No (n = 5) 3 premature births (33, 33.6 and 34 wks) No No Volvulus and incarcerated uterus 0...…”

“…This adverse event could possibly be attributed to the LGE, because this patient also underwent laparotomy after the LGE and suffered from severe gastrointestinal bleeding. The other two temporally related adverse events in the first trimester were both elective abortions, and were therefore classified as etiologically unrelated to the LGE [ 17 , 18 ].…”

A rare case of myeloid sarcoma presenting as anal fissure

“…Very rarely it can involve the gastrointestinal tract (1,2), and in these cases it may involve the mucosa from the oral cavity to the colon-rectum. Location in gallbladder, bile duct, pancreas and liver has also been described (1).…”

“…Hystopathologically, myeloid sarcoma has to be differentiated by non-Hodgkin lymphoma or undifferentiated carcinoma. Staining with immunohystochemical markers allows the definitive diagnosis (1), and in these cases, differential diagnosis with other diseases can be challenging (7,8).…”

“…It has also been termed chloroma, granulocytic sarcoma, myeloblastoma neoplasm or extramidollary myeloid tumor (1). Myeloid sarcoma may develop in patients with acute myeloid leukemia, myeloproliferative neoplasms or myelodisplastic syndrome, sometimes-occurring months or years before the initial manifestation of the systemic disease.…”