Granulocytic sarcoma of the pancreas successfully treated with intensive chemotherapy and stem cell transplantation

Abstract

A case of preleukemic granulocytic sarcoma of pancreas is presented. Pancreas is a well described site of secondary metastasis of solid tumors, but occasionally it has been reported as the primary site of leukemia. Like other cases reported in the literature, the present case was initially misdiagnosed as malignant lymphoma. We highlight the importance of an accurate immunohistochemical diagnosis and of an early and intensive acute myeloid leukemia-like treatment for these cases representing an uncommon and aggressive form of acute leukemia.

Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients

“…In particular, 55 had been collected at the Hematopathology Unit of Bologna University between 1990 and 2004: of these, five had been provided by a Dermatologyoriented Institution and three had been the object of brief reports. [12][13][14] In all instances, formalin-fixed, paraffin-embedded tissue blocks were available, as were the following information: age and sex of the patients, sites of MS presentation, original morphologic diagnoses and presence of previous, concomitant or following AML, MPD, MDS or non-hematopoietic tumor. Follow-up data were available in 67 patients.…”

“…1,4,5,12,40,41 However, recent studies suggest that either highly specific drugs 42 or aggressive schedules should also be applied to the latter, if one aims to achieve stable remission and cure. 5,14,15 So far, no definitive conclusion has been drawn concerning MS optimal treatment.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] It may develop de novo or concurrently with acute myeloid leukemia (AML), myeloproliferative disorder (MPD) or myelodysplastic syndrome (MDS). 1,2,6,11,[13][14][15][16][17][18][19][20] Interestingly, MS may be the first evidence of AML or precede it by months or years. 1,13 Finally, it can represent the initial manifestation of relapse in a previously treated AML in remission.…”

Myeloid Sarcoma of the Hepatobiliary System: A Case Series and Review of the Literature

“…Eighteen patients (35%) had de novo isolated MS, 5 (10%) presented with isolated relapse [33,45,49,51,57] and the remainder presented with systemic disease, mainly in association with AML (either on initial presentation or relapse). Six (18%) of the AML patients had an antecedent hematologic disorder and MS was, in most cases, diagnosed prior to or concurrently with transformation (our case 3) [20,22,23,32,43]. …”

Clinicoradiological characteristics, management and prognosis of primary myeloid sarcoma of the central nervous system: A report of four cases

“…However, MS may occasionally occur de novo without any evidence of concomitant hematological disease (5,6). MS most frequently affects the bone, periosteum, lymph nodes and skin, but unusual presentations of MS in the breast, ovary, rectum, pancreas and urinary bladder have also been reported in previous studies (7)(8)(9). Central nervous system involvement of MS (CNS-MS) is very rare, with a reported incidence of 3.25% in patients with MS (10).…”