Primary breast myeloid sarcoma: A case report and literature review

Abstract

Myeloid sarcoma (MS) is a rare extramedullary tumor originating from immature bone marrow cells. MS of the breast is an extremely uncommon disease with non-specific clinical and radiological features. The present case report describes a distinctive case of MS of the breast, which posed diagnostic challenges due to the absence of typical imaging characteristics at the time of presentation. The patient was a 58-year-old woman who presented with a breast mass. Further examination and testing confirmed the diagnosis of MS in the right breast, with metastases to the right iliac, pubic and ischial regions. Immunohistochemical analysis identified metastatic tumors distinguished by the expression of a number of markers, including Ki-67, myeloperoxidase and cluster of differentiation 43. The patient underwent six cycles of chemotherapy with a regimen comprising etoposide, methylprednisolone, cytarabine and cisplatin, and 28 cycles (56 cGy each) of consolidation radiotherapy. Extensive examination and long-term follow-up revealed no further tumor recurrence or metastasis. Myeloid sarcomas of the breast typically manifest as palpable masses requiring diagnostic imaging. However, due to the rarity of MS of the breast without any signs of leukemia, its diagnosis and treatment are challenging. The present case report highlights the importance of maintaining high clinical, radiological and pathological standards when diagnosing this disease. Additionally, a comprehensive review of the literature on breast MS is provided. This highlights the necessity for clinicians to consider this rare diagnosis in patients presenting with a breast mass, to facilitate the appropriate treatment and prevent unnecessary procedures such as mastectomies.