Isolated myeloid sarcoma presenting with small bowel obstruction: a case report

Abstract

Background: Myeloid sarcoma (MS) is a solid tumor consisting of myeloid blasts or immature myeloid cells, which are unusual outside the bone marrow. Case presentation: We present a rare case of isolated myeloid sarcoma of the small bowel in a 54-year-old man who was admitted to our hospital with repeated symptoms of intestinal obstruction. A small bowel series via an ileus tube revealed severe jejunal obstruction. Computed tomography revealed that the obstruction was likely caused by a jejunal tumor. The patient underwent laparoscopy-assisted partial resection of the jejunum with lymphadenectomy. Histopathological examination of the surgical specimen confirmed that MS had been responsible for the obstruction. Conclusions: Patients with MS require systemic chemotherapy, as do patients with acute myeloid leukemia. Hence, an early, accurate diagnosis is imperative for treating this malignancy. It is also important to list MS in the differential diagnosis of a small bowel tumor, even in nonleukemic patients.

A Rare Case of Partial Small Bowel Obstruction Secondary to Intestinal Myeloid Sarcoma

“…Surgical resection, while sometimes necessary due to complications such as obstruction, shows no actual improvement in overall survival [5]. Reports suggest that up to half of patients with MS are initially misdiagnosed, often as having a primary or metastatic malignant tumour, particularly malignant lymphoma [7][8][9][10][11][12][13][14][15][16][17]. This mis-or delayed diagnosis has been reported to occur both at initial primary differential diagnosis and even post-biopsy or resection with misinterpretation of histopathology [9][10][11]17].…”

“…Early and accurate diagnosis of MS is imperative due to its impact on treatment regimens [1,9]. The prognosis of isolated MS is variable but better if diagnosed early [14].…”

Myeloid Sarcoma Presenting as Obstructive Jaundice

“…The most common sites associated with isolated MS are the skin (28–36%), lymph nodes (13–16%), testis (2.9–6.5%), intestine (6.5–8.9%), bone (3.3–4.9%), and central nervous system (3.2%) [ 3 , 7 ]. Case reports have been published showing primary MS involving GI tract and associated organs that include the stomach [ 8 , 9 , 10 , 11 ], gallbladder [ 12 ], pancreas [ 13 ], small intestine [ 14 , 15 , 16 , 17 , 18 , 19 ], colon [ 20 ], and mesentery [ 21 ]. These articles have been summarized in Table 1 .…”

Non-Mass-Forming Myeloid Sarcoma of the Colon Presenting With Diarrhea

“… 1 It is most frequent in the skin, lymph nodes, or bones; it rarely involves the gastrointestinal tract. 2 , 3 When MS occurs in the gastrointestinal tract, it has a predilection for involving the small bowel and usually presents with intestinal obstruction related to a mass. 3 , 4 A spectrum of imaging and endoscopic findings has been described including exophytic luminal masses, polyps, bowel wall thickening, and ulcerated lesions.…”