Myeloid sarcoma of the tongue as a first manifestation of acute promyelocytic leukemia: A case report

Ignacio-Cconchoy, Felipe L.; Benítes-Zapata, Vicente A.; Yanac-Avila, Rommel L.; Vela-Velásquez, César Tadeo

doi:10.1016/j.rpor.2019.12.026

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…Patients with MS presenting with soft-tissue masses can present a diagnostic challenge given the broad differential diagnoses, including infectious causes and second primary malignancies such as melanoma or Hodgkin's lymphoma [ 8 ]. The compression of the esophagus in our patient resulted in dysphagia, a rare presentation of MS, with few reported cases [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 75%

Dysphagia as an Initial Presentation of Acute Myeloid Leukemia: A Rare Presentation of Myeloid Sarcoma

Salih,

Olusoji,

Nnwankwo

et al. 2024

Cureus

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Myeloid sarcoma (MS) represents a unique clinical presentation of acute myeloid leukemia (AML). This report describes a case of MS in a 66-year-old man who presented with dysphagia, nausea, vomiting, anorexia, and fatigue. Generalized lymphadenopathy was noted on physical exam and confirmed by CT scans which also showed diffuse esophageal wall thickening. Axillary lymph node biopsy was positive for MS. Bone marrow biopsy confirmed AML with 88% blasts. The patient received induction chemotherapy with decitabine and venetoclax and was planned for four cycles of treatment over three months while monitoring the response.

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Section: Discussionmentioning

confidence: 75%

Dysphagia as an Initial Presentation of Acute Myeloid Leukemia: A Rare Presentation of Myeloid Sarcoma

Salih,

Olusoji,

Nnwankwo

et al. 2024

Cureus

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“…Chloromas are rather rare at first presentation but occur more frequently in patients with relapsing disease ( 9 – 13 ). To date, only few reports on primary extramedullary manifestation of APL exist ( 5 , 14 – 29 ), e.g. the clinical courses of a 29-year-old male presenting with hematochezia resulting from a chloroma in the colon ( 14 ), and a 38-year-old female patient complaining about gingival bleeding, abnormal uterine bleeding and headache emanating from an extensive intracranial chloroma.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Extramedullary Acute Promyelocytic Leukemia: An Unusual Case and Mini-Review of the Literature

et al. 2022

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BackgroundAcute promyelocytic leukemia (APL) constitutes a serious hematological emergency necessitating rapid diagnosis and therapy to prevent lethal bleedings resulting from APL-induced thrombocytopenia and coagulopathy. Atypical manifestations of APL, such as extramedullary disease at first presentation, pose diagnostic challenges and delay the onset of appropriate therapy. Nevertheless, extramedullary manifestations of APL are mostly accompanied by blood count alterations pointing to an underlying hematological disease. In this report, we present the first case of APL bearing close resemblance to a metastasized laryngeal carcinoma with normal blood counts and absent coagulopathy.Case PresentationA 67-year-old man with a previous history of smoking was admitted to our hospital with progressive hoarseness of voice, odynophagia, dysphagia and exertional dyspnea. Laryngoscopy revealed a fixed right hemi larynx with an immobile right vocal fold. Imaging of the neck via magnetic-resonance imaging (MRI) and positron emission tomography–computed tomography (PET/CT) with F-18-fluordeoxyglucose (FDG) showed a large hypermetabolic tumor in the right piriform sinus and tracer uptake in adjacent lymph nodes, highly suspicious of metastasized laryngeal carcinoma. Surprisingly the histological examination revealed an extramedullary manifestation of acute promyelocytic leukemia. Remarkably, blood counts and coagulation parameters were normal. Moreover, no clinical signs of hemorrhage were found. PML-RARA fusion was detected in both laryngeal mass and bone marrow. After diagnosis of APL, ATRA-based chemotherapy was initiated resulting in complete remission of all APL manifestations.ConclusionsThis is the first case report of APL initially presenting as laryngeal chloroma. Additionally, we performed a comprehensive literature review of previously published extramedullary APL manifestations. In aggregate, a normal blood count at first presentation constitutes an extremely rare finding in patients initially presenting with extramedullary APL manifestations.

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“…Although the infiltration of malignant cells into the oral tissues is not an uncommon feature in leukemic patients, especially in patients with acute leukemia, infiltration of the tongue is rare 19 . On the other hand, while myeloid sarcomas can occur in any part of the body, the involvement of the oral cavity is uncommon, with only 37 cases reported according to the Yap et al 20 report.…”

Section: Discussionmentioning

confidence: 99%

“…It can affect the oral cavity on the tonsils, lips, gingiva, palate and tongue. 20 Hitherto, there is not a precise percentage of the several oral site's involvements. Like our case, another recent case-report by Ignacio-Cconchoy et al 20 also described oral myeloid infiltration in the tongue as the first manifestation of an oncohematologic disease.…”

Section: Discussionmentioning

confidence: 99%

Myeloid sarcoma in the tongue

et al. 2020

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Myeloid sarcoma of the tongue as a first manifestation of acute promyelocytic leukemia: A case report

Cited by 8 publications

References 19 publications

Dysphagia as an Initial Presentation of Acute Myeloid Leukemia: A Rare Presentation of Myeloid Sarcoma

Dysphagia as an Initial Presentation of Acute Myeloid Leukemia: A Rare Presentation of Myeloid Sarcoma

Case Report: Extramedullary Acute Promyelocytic Leukemia: An Unusual Case and Mini-Review of the Literature

Myeloid sarcoma in the tongue

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