Myeloid sarcoma, a rarity of the head and neck region - A case report

Abstract

Myeloid sarcoma is a rare disease, where a mass (tumour) of either myeloblasts or immature myeloid cells conglomerate in extramedullary anatomic sites. It may arise de-novo or it may present in association with acute myeloid leukemia. It can also occur in patients with myelodysplastic syndromes, myeloproliferative disorders, and as blast transformation in myeloproliferative neoplasia. Myeloid sarcoma of the head and neck area can pose a diagnostic challenge because of the low frequency of occurrence, and the vast diversity of tumours occurring from multiple lineages in this anatomic region. This can lead to a broad spectrum of various differential diagnoses. Therefore, a high index of suspicion is required when dealing with a possible case of myeloid sarcoma, as it is a time sensitive diagnosis with various diagnostic dilemmas. Here, we report an example, a case of tonsillar myeloid sarcoma. We wish to highlight the investigations that helped us procure this diagnosis in a timely manner.

Rare Presentation of Myeloid Sarcoma: Nasopharyngeal Myeloid Sarcoma

“…Hypertrophy of the lingual and palatine tonsils was detected in the endoscopic examination. Biopsies taken from both tonsils were compatible with myeloid sarcoma and the patient opted for treatment with palliative chemotherapy but he died due to the rapid progression of the disease (7)where a mass (tumour. In an article three cases of myeloid sarcoma were presented:…”

“…Patients with myeloid sarcoma combined with AML have a poor prognosis. Even after chemotherapy with or without radiotherapy, as many as 85% of the patients relapse within 1 year ( 12) and these relapses are usually the cause of death (6)(7)(8).…”