Bilateral orbital myeloid sarcoma preceding acute myeloid leukemia in an adult: a case report and review of the literature

Abstract

BackgroundAcute myeloid leukemia is typically a disease of the older population and presents mostly in the fifth decade of life. Myeloid sarcoma is a rare initial presentation of acute myeloid leukemia. Previously it has only been documented in children and younger patients.Case PresentationWe present an unusual case of retro-orbital myeloid sarcoma as an initial presentation of acute myeloid leukemia in a 43-year-old Caucasian man, with rearrangement of chromosome 11q23 involving the MLL gene.ConclusionsWe present an unusual case of retro-orbital myeloid sarcoma as an initial presentation of acute myeloid leukemia in a 43-year-old man, with rearrangement of chromosome 11q23 involving the MLL gene.

Isolated myeloid sarcoma as the first manifestation of acute myeloid leukemia: a case study

“…Other common markers include CD4, CD15, CD30, CD34, CD56, CD99, CD117, and Tdt; albeit our patient only expressed CD34, CD117, and Tdt . Expression of CD 117, a transmembrane protein receptor encoded by the c‐kit proto‐oncogene, has been associated with poorer outcomes . Immunohistochemistry for antimyeloperoxidase (MPO) has been shown to be the most useful and sensitive marker in differentiating between myeloid and nonmyeloid cells.…”

“…Retinal lesions are among the most common locations of leukemia, occurring in up to 69% of patients [8,9]. Although MS can involve any ocular tissue, MS involving the eyelid is less common and is usually found secondary to orbital involvement [10,11]. Despite a case reported of MS involving the eyelid and caruncles as the first sign of AML relapsing after bone marrow transplant, there remain limited reports about MS in the eyelid as the initial manifestation of AML, such as this case [8].…”

Acute unilateral proptosis in childhood: suspect myeloid sarcoma

“…Myeloid sarcoma constitutes approximately 2.5%-8% of all AML cases [ 1 - 5 ]. It has been more commonly reported from Asian, African, and Latin American populations, between 6 and 8 years old, with male predominance [ 1 - 8 ]. On the contrary, both of our patients were females.…”

“…Usually, the first presentation of children with AML is easy bruising, fever, joint pain, and weight loss [3][4][5][6]. Ophthalmological features of myeloid sarcoma constitute proptosis, blepharoptosis, lacrimal gland mass, conjunctival mass, and uveitis [2,3,[6][7][8][9]. The proptosis is commonly non-axial due to the proliferation of myeloid blast cells in the extraconal space [1,[7][8][9].…”

“…Ophthalmological features of myeloid sarcoma constitute proptosis, blepharoptosis, lacrimal gland mass, conjunctival mass, and uveitis [2,3,[6][7][8][9]. The proptosis is commonly non-axial due to the proliferation of myeloid blast cells in the extraconal space [1,[7][8][9]. The orbital imaging commonly shows homogenous, irregular soft-tissue mass causing encasement of extraocular muscles and lacrimal gland with lateral orbital predominance [1,[7][8][9].…”