Isolated myeloid sarcoma in the pancreas and orbit: A case report and review of literature

Abstract

Myeloid sarcoma (MS) is a type of extramedullary solid haematological tumour. Myeloid sarcoma is classified into two types based on whether onset of the disease is complicated by haematologic diseases: extramedullary infiltration of leukaemia (leukaemic MS) and isolated myeloid sarcoma. The incidence of isolated myeloid sarcoma is low. In particular, isolated myeloid sarcoma involving the pancreas is extremely rare and prone to misdiagnosis. This case report describes the long and eventful diagnostic process of a case of myeloid sarcoma involving the pancreas and orbit. Due to a lack of typical clinical manifestations and imaging characteristics, the patient underwent several rounds of treatment without a confirmed diagnosis. Eventually, the final diagnosis was pathologically confirmed using several types of biopsies and immunohistochemical detection. To date, this type of disease has not been reported in the literature. This case report describes the detailed diagnostic process and discusses the strategies used for diagnosis, which will facilitate the diagnosis of such diseases in the future.

Myeloid sarcoma of the pancreas

“…Other symptoms, such as jaundice, anemia, weight loss, fatigue, etc, are relatively rare, which may be due to the rarity of related cases (Table 1 ). [ 12 – 20 ]…”

“…Of the 10 cases we searched, 7 patients had pancreatic MS in the head of the pancreas, and 3 patients in the tail of the pancreas. [ 12 – 20 ] Our case is also a patient with MS at the head of the pancreas, so we suspect that pancreatic MS is more likely to occur at the head of the pancreas, but more related cases are needed.…”

“…It is reported that most of the patients are hyperleukemic, but a considerable number of patients have normal hemogram, and other conditions such as anemia, hypoleukaemia, and thrombocytopenia also exist. [ 12 – 20 ] Due to the small number of cases, the typical hemogram of these patients is still uncertain.…”

“…Bone marrow biopsy can be a diagnostic method, but due to the existence of isolated extramedullary MS, we cannot rule out MS. [ 12 , 16 , 19 , 20 ] The final diagnosis usually depends on immunohistochemistry (IHC).…”

Pattern of Orbital Diseases at a Tertiary Oculoplastic Center

“…16 Leukemia was seen in one patient which is extremely rare as a cause of proptosis. 17 Rare tumors of orbit include Orbital teratoma. 18 Other tumors include maxillary tumor invading the orbit, brain tumors and neuroblastoma.…”