Leukemic dermal infiltrates at permanent indwelling central venous catheter insertion sites

Abstract

Three cases of leukemic dermal infiltrates at permanent indwelling central venous catheter insertion sites in patients with acute myelogenous leukemia are reported. Two patients had a localized soft tissue mass at the previous permanent indwelling catheter insertion site as the sole initial manifestation of relapse after achieving complete remission and undergoing bone marrow transplantation. The third patient had catheter tunnel sepsis preceding leukemic dermal infiltration. A review of the English language literature showed that this condition is rare with no specific pathogenetic mechanisms identified. Patients with unresolved catheter tunnel infections in acute leukemia and persistent chest wall masses that appear after a previous permanent indwelling catheter should have a biopsy done and be treated promptly. Cancer 68:2281–2283, 1991.

Extramedullary Involvement at Relapse in Acute Promyelocytic Leukemia Patients Treated or Not With All-Trans Retinoic Acid: A Report by the Gruppo Italiano Malattie Ematologiche dell’Adulto

“…[15][16][17] The occurrence of extramedullary disease (EMD) at presentation or at relapse has long been considered a rare event in APL. [18][19][20][21] Conversely, EMD localization is known to develop in a sizable proportion (3% to 8%) of acute myelogenous leukemias, being more frequently reported in patients with myelomonocytic and monocytic forms (M4 and M5 French-American-British subtypes). 22,23 Following the advent of ATRA treatment, an increasing number of reports have been published on EMD localization in APL, particularly at the time of relapse, 18,[24][25][26][27][28][29][30][31][32][33][34][35] with the CNS and skin being described as the sites most frequently involved.…”

Subcutaneous Plasmacytoma Metastasis Precipitated by Tunneled Central Venous Catheter Insertion

“…However, clues that may have led to the correct diagnosis sooner were delayed lesion development after catheter removal and considerable focal pain at the abnormal site. Authors reporting cases of port site breast cancer and leukemic implants have advocated prompt biopsy of persistent chest wall masses [16, 17]. Although a percutaneous biopsy would have still been appropriate if plasmacytoma had been an earlier diagnostic consideration, a 2-3-cm incision may have been avoided in lieu of a small needle puncture.…”

Case Report: Very Late, Atypical Extra-Medullary Relapse in a Patient With Acute Promyelocytic Leukemia (APL) Rescued With a Transplant-Free Approach

“…Late relapses in acute promyelocytic leukemia (APL) patients that occur three or more years from the achievement of complete remission (CR) are very rare, and relapses beyond 7 years from the initial diagnosis are exceptional. A few cases of late APL relapses treated with all-trans retinoic acid (ATRA) in combination with other approaches have been reported (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Most late relapses are the result of the identical immunophenotypic, cytogenetic, and molecular features already present at diagnosis, suggesting that relapse emerged through the initial leukemic clone (3)(4)(5).…”