29 June 2018 : Case report
Peritoneal Myeloid Sarcoma in a Patient Treated for a Testicular Seminoma
Challenging differential diagnosis, Rare disease
Raffaele Longo1ABCDEF*, Véronique Dorvaux2ABDE, Eric Chatelain3BCDE, Philippe Quétin4ABDE, Francesca Plastino1BDEF, Nada Eid1BCDE, Nathalie Marcon5BCDE, Laurent Hennequin6BCDE, Marco Campitiello1BCDEDOI: 10.12659/AJCR.910434
Am J Case Rep 2018; 19:763-766
Abstract
BACKGROUND: Myeloid sarcoma is a rare extramedullary soft tissue neoplasm composed of myeloblastic cells, usually associated to hematologic tumor disorders and a poor prognosis. Its diagnosis is very difficult as radiological images are not specific. Histology and immunohistochemistry are necessary for an accurate diagnosis.
CASE REPORT: We report the case of 46-year-old, Caucasian, non-smoker male, treated in 2014 by orchiectomy and systemic chemotherapy for a stage IIB testicular seminoma. Considering the rapid increase of lactate dehydrogenase (LDH) levels without any evident medical reason, a computed tomography/positron emission tomography (CT/PET) scan was performed and revealing a diffuse, nodular, peritoneal tumor infiltration associated with multiple mesenteric and mediastinal adenopathies. Laparoscopy confirmed a diffuse tumor infiltration of the peritoneum. Histology and immunohistochemistry were consisted with the diagnosis of a myeloid monoblastic sarcoma. Cytology of bone marrow documented an monocytic acute myeloid leukemia. The patient started a systemic induction chemotherapy with high dose cytarabine and idarubicin that was complicated by an infectious pneumonia and colitis, and a grade IV thrombocytopenia leading to a brain subdural hemorrhage and quickly to patient’s death.
CONCLUSIONS: We describe a rare, peritoneal, myeloid sarcoma in a young patient who had been treated by systemic chemotherapy for testicular seminoma 4 years earlier. The patient was clinically asymptomatic and presented only elevated LDH levels without any evident clinical reason. Considering the persistence of this biochemical abnormality, more investigations were performed leading to a diagnosis of peritoneal myeloid sarcoma associated with monocytic acute myeloid leukemia, probably secondary to the past chemotherapy.
Keywords: Leukemia, Myeloid, Acute, Sarcoma, Myeloid, Testicular Neoplasms
In Press
Case report
Successful Treatment of Cervical Spondylolysis with Grade-II Spondylolisthesis using Single-Level ACDF: A C...Am J Case Rep In Press; DOI: 10.12659/AJCR.943823
Case report
Over-the-Scope-Clip Iatrogenic Ligation of the Gastroduodenal Artery: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.943891
Case report
A 55-Year-Old Woman Presenting with a Second Diagnosis of Craniopharyngioma Following Diagnosis and Success...Am J Case Rep In Press; DOI: 10.12659/AJCR.943300
Case report
Remarkable Recovery After Severe Gunshot Brain Injury: A Comprehensive Case Study of Functional RehabilitationAm J Case Rep In Press; DOI: 10.12659/AJCR.941601
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250