Granulocytic sarcoma of the stomach

Abstract

An 18-year-old male underwent an allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myeloid leukemia (CML) in the first late chronic phase. On day 132, he was readmitted to the hospital with nausea, vomiting and nodular lesions on endoscopy. A diagnosis of granulocytic sarcoma of the stomach was made. Bone marrow cytogenetic analysis for the Philadelphia chromosome and nested polymerase chain reaction for BCR-ABL1 were both negative. Immunosuppression was abruptly discontinued, and by day 180, all gastric lesions had completely disappeared. However, there were histological signs of graft-versus-host disease. The patient developed progressive anorexia and elevated hepatic enzymes, which prompted the reintroduction of cyclosporine. Considering the risk of another relapse, imatinib mesylate (IM) 600 mg/day was started. The patient Is condition improved, and there was no evidence of disease recurrence at 36 months after relapse. Relapse of CML is the commonest cause of treatment failure after allo-HSCT. On rare occasions, a localized extramedullary presentation is seen. Unless properly treated, other extramedullary relapse sites and/or marrow infiltration usually occur. Withdrawal of immunosuppression, along with IM therapy seems to be an acceptable approach in this setting.

Gastric myeloid sarcoma with rapid growth

“…Most MS develop with AML or myelodysplastic syndrome and recognize swollen fold or redness polypoid lesion 2 . Few have reported isolated MS or the shape of the submucosal tumor 3 like our case. Given our case, although isolated MS in the stomach grew rapidly, it could be treated with appropriate chemotherapy.…”

Leukemia in gastrointestinal organs as cause of treatment failure: 378 cases analyzed

“…In the other, after stomach nodules were diagnosed, immunosuppressive drugs were stopped and by 6 months, there was no evidence of tumor. He then received imatinib and was well at 5 years …”

Repeated donor lymphocyte infusions overcome a myeloid sarcoma of the stomach resulting from a relapse of acute myeloid leukemia after allogeneic cell transplantation in long-term survival of more than 10 years

“…Involvement of the skin, lymph nodes, central nervous system, small intestine, eyes, sockets, bones, and breasts has been previously reported. Cases arising in the stomach are rare, with approximately 20 cases reported in the literature [14][15][16].…”