Pancreatic Myeloid Sarcoma

Abstract

Myeloid sarcoma is an isolated extramedullary tumor mass consisting of immature myeloid cells. It is characterized by highly variable outcomes and usually disrupts the normal architecture of the normal tissue in which it originates. It may occur de novo or be associated with other hematological malignancies. Clinical presentation of myeloid sarcomas can be highly variable based on the tumor site, size, and extent of tissue involvement. The diagnosis of myeloid sarcoma is challenging and requires a high index of suspicion. Tissue sampling followed by the use of auxiliary studies is essential for diagnosis. Moreover, bone marrow sampling is necessary to exclude morrow involvement. Currently, the recommended therapeutic regimens for myeloid sarcoma are similar to those for acute myeloid leukemia. Much work remains to be accomplished as myeloid sarcomas, if initially missed or misdiagnosed, have poor overall survival rates. Furthermore, prognostic factors for this malignancy remain poorly understood.

Myeloid sarcoma of the pancreas

“…Other symptoms, such as jaundice, anemia, weight loss, fatigue, etc, are relatively rare, which may be due to the rarity of related cases (Table 1 ). [ 12 – 20 ]…”

“…Of the 10 cases we searched, 7 patients had pancreatic MS in the head of the pancreas, and 3 patients in the tail of the pancreas. [ 12 – 20 ] Our case is also a patient with MS at the head of the pancreas, so we suspect that pancreatic MS is more likely to occur at the head of the pancreas, but more related cases are needed.…”

“…It is reported that most of the patients are hyperleukemic, but a considerable number of patients have normal hemogram, and other conditions such as anemia, hypoleukaemia, and thrombocytopenia also exist. [ 12 – 20 ] Due to the small number of cases, the typical hemogram of these patients is still uncertain.…”

“…Bone marrow biopsy can be a diagnostic method, but due to the existence of isolated extramedullary MS, we cannot rule out MS. [ 12 , 16 , 19 , 20 ] The final diagnosis usually depends on immunohistochemistry (IHC).…”

The transformation of isolated gastric myeloid sarcoma into acute myeloid leukemia presenting with a complex karyotype and TLS-ERG gene fusion

“…MS can occur de novo or concurrent with other hematological malignancies, such as acute myeloid leukemia (AML), myeloproliferative neoplasm, or myelodysplastic syndrome. [ 2 ] Isolated MS, also known as primary or de novo MS occurs without bone marrow or other extramedullary site involvement at the time of diagnosis and accounts for 1%–2% of MS. [ 3 ] According to 2016 revision World Health Organization classification of myeloid neoplasms and acute leukemia, MS is recognized as a subtype of AML. [ 4 ] Existing clinical evidence indicates that isolated MS frequently occurs in the skin, lymph nodes, bone, brain, breast, cervix, and visceral organs.…”