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Wang D, He K, Sroussi H, Treister N, Luskin M, Villa A, Woo SB, Shazib MA. Oral myeloid sarcoma as an uncommon manifestation of acute myeloid leukemia: A case series and review of the literature. J Am Dent Assoc 2021; 152:393-400.e8. [PMID: 33926625 DOI: 10.1016/j.adaj.2021.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/13/2020] [Accepted: 01/31/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OVERVIEW Oral myeloid sarcoma (MS) is an extramedullary tumor that can occur in the setting of acute myeloid leukemia, either as the first sign of an underlying disease or later in the course of disease. The authors' aim was to present the clinical features of oral MS and review the literature. CASE DESCRIPTION Case 1 was an 82-year-old woman with an asymptomatic erythematous swelling on the maxillary gingiva and no history of hematologic malignancy. Case 2, a 65-year-old man, and case 3, a 58-year-old woman, each had a history of acute myeloid leukemia and a painful ulcer on the palatal mucosa and an asymptomatic ulcer on the lower lip mucosa, respectively. Case 1 was treated with focal radiation then chemotherapy and achieved complete remission initially, but died of relapse 2 years after diagnosis. Case 2 received radiotherapy and immunotherapy and had a complete response. Case 3 received chemotherapy and achieved remission initially, but relapsed and is undergoing investigational targeted therapies. CONCLUSIONS AND PRACTICAL IMPLICATIONS Oral MS can manifest as gingival or mucosal swelling or ulceration and can indicate onset or relapse of associated hematologic malignancies, which often have a poor prognosis. Because patients with oral findings are likely to seek treatment from their dentists first, oral clinicians should maintain a broad differential diagnosis list when evaluating oral lesions, especially if treatment prescribed for a more common diagnosis fails to resolve the lesion.
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Hu YG, Deng XH, Lei W, Li XL. Clinical characteristics and management of primary granulocytic sarcoma of the oral cavity: A case report and literature review. Medicine (Baltimore) 2020; 99:e22820. [PMID: 33120806 PMCID: PMC7581149 DOI: 10.1097/md.0000000000022820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Granulocytic sarcoma (GS) is a commonly occurring tumor comprising immature myeloid cells, which are usually related to acute or chronic myelocytic leukemia. The tumor rarely precedes leukemia without bone marrow involvement and is called primary GS. Although primary GS can occur in any body part, the involvement of the oral cavity is uncommon. PATIENT CONCERNS A 49-year-old woman hospitalized at the Department of Plastic and Maxillofacial Surgery presented with a growing mass in her left maxillary hard palate dating two months back. No obvious physical findings were noted during general examination. She was diagnosed with an oral ulcer at a local clinic, and received antibiotics. However, the symptoms did not improve; the mass became bigger and painful. DIAGNOSIS An incisional biopsy of the oral mass was performed, the immunohistochemistry showed that the tumor cells tested positive for myeloperoxidase, CD4, BCL-2, KI-67. Bone marrow aspiration was negative for malignant cells, and the laboratory test results revealed only monocytosis. Standard bone marrow cytogenetic analysis showed a normal karyotype and leukemia-related fusion gene detection was normal. Therefore, the final diagnosis was intraoral primary GS. INTERVENTIONS The patient was treated with a chemotherapy regimen based on idarubicin and cytarabine arabinoside. OUTCOMES After 2 cycles of idarubicin and cytarabine arabinoside regimen chemotherapy, the patient achieved complete remission. The tumor was barely visible in the left maxillary hard palate. There has been no evidence of disease spread and progression after 1 year of follow-up. CONCLUSIONS Careful morphological and immunohistochemical analyses, correlating with clinical data are necessary to establish the diagnosis of oral primary GS. Early aggressive systemic chemotherapy can effectively relieve symptoms, significantly reducing primary GS conversion into acute myelocytic leukemia and prolonging overall survival.
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Affiliation(s)
- Yun-Gang Hu
- Department of Plastic and Maxillofacial Surgery, The People's Affiliated Hospital of Nanchang University
| | - Xiao-Hua Deng
- Department of Plastic and Maxillofacial Surgery, The People's Affiliated Hospital of Nanchang University
| | - Wei Lei
- Department of Plastic and Maxillofacial Surgery, The People's Affiliated Hospital of Nanchang University
| | - Xiao-Lin Li
- Key Laboratory of Maxillofacial Plastic and Reconstructive surgery, Jiangxi, People's Republic of China, 92 Aiguo road, Nanchang, Jiangxi, People's Republic of China
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Nunes LFM, Rocha AL, Magalhães GHR, de Melo FHC, Travassos DV, Mesquita RA, Silva TA. Intraoral granulocytic sarcoma as a manifestation of myelofibrosis: A case report and review of the literature. SPECIAL CARE IN DENTISTRY 2018; 38:409-420. [DOI: 10.1111/scd.12325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/09/2018] [Accepted: 07/13/2018] [Indexed: 12/25/2022]
Affiliation(s)
| | - Amanda Leal Rocha
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Gustavo Henrique Romani Magalhães
- Department of Hematology and Oncology; Ambulatory of Chronic Myeloproliferative Diseases; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | | | - Denise Vieira Travassos
- Department of Community and Preventive Dentistry; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
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Gaal A, Chisholm KM, Egbert M. How Rare Is an Oral Presentation of Myeloid Sarcoma in the Infant? J Oral Maxillofac Surg 2018; 76:561-568. [DOI: 10.1016/j.joms.2017.08.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/26/2017] [Accepted: 08/26/2017] [Indexed: 10/18/2022]
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Pau M, Beham-Schmid C, Zemann W, Kahr H, Kärcher H. Intraoral Granulocytic Sarcoma: A Case Report and Review of the Literature. J Oral Maxillofac Surg 2010; 68:2569-74. [DOI: 10.1016/j.joms.2009.09.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2009] [Revised: 06/29/2009] [Accepted: 09/15/2009] [Indexed: 01/06/2023]
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Yoon AJ, Pulse C, Cohen LD, Lew TA, Zegarelli DJ. Myeloid sarcoma occurring concurrently with drug-induced gingival enlargement. J Periodontol 2006; 77:119-22. [PMID: 16579712 DOI: 10.1902/jop.2006.77.1.119] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Myeloid sarcoma is an extramedullary malignancy of myeloblasts. An unusual case of myeloid sarcoma presenting in the gingiva and affected by drug-induced gingival enlargement is presented. METHODS A 63-year-old male taking amlodipine for his hypertension presented with a 3-week gingival enlargement. Although the obvious clinical impression was that of drug-induced gingival enlargement, an incisional biopsy was performed to corroborate chemical enlargement while ruling out diseases such as lymphoma and leukemia. RESULTS Microscopic examination of the thickened gingiva revealed surface stratified squamous epithelium having needle-like rete pegs characteristic of drug-induced gingival enlargement. Beneath the surface epithelium, the fibrous tissue was virtually replaced by a dense infiltrate of malignant cells. Immunohistochemical studies were performed with CD117 and myeloperoxidase identifying the malignant cell population as myeloblasts, leading to a diagnosis of myeloid sarcoma. CONCLUSION Myeloid sarcoma and hematopoietic malignancies must be included in a differential diagnosis of gingival enlargement until the definitive diagnosis is reached by histologic/laboratory examination.
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Affiliation(s)
- Angela J Yoon
- Department of Pathology, Division of Oral Pathology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10032, USA
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Koudstaal M, van der Wal K, Lam K, Meeuwis C, Speleman L, Levin M. Granulocytic sarcoma (chloroma) of the oral cavity: Report of a case and literature review. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ooe.2005.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Stoopler ET, Pinto A, Alawi F, Raghavendra S, Boyce R, Porter D, Sollecito TP. Granulocytic sarcoma: An atypical presentation in the oral cavity. SPECIAL CARE IN DENTISTRY 2004; 24:65-9. [PMID: 15200230 DOI: 10.1111/j.1754-4505.2004.tb01681.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Acute myelogenous leukemia (AML) is a hematologic disorder that is characterized by an abnormal proliferation of immature myeloid cells. Granulocytic sarcomas are clusters of leukemic myeloid cells that may develop as a result of AML. Oral manifestations of AML are common and often involve enlargements of the gingiva and/or mucosal tissue from direct leukemia cell infiltration. We describe the case history of a 50-year-old man who had an ulcerative lesion of the oral mucosa that was determined to be a granulocytic sarcoma of AML-MO subtype. The combination of both the subtype and clinical presentation of the leukemia makes this presentation unusual, and to the best of our knowledge, of a type that has not been previously reported in the literature.
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Antmen B, Haytac MC, Sasmaz I, Dogan MC, Ergin M, Tanyeli A. Granulocytic sarcoma of gingiva: an unusual case with aleukemic presentation. J Periodontol 2004; 74:1514-9. [PMID: 14653399 DOI: 10.1902/jop.2003.74.10.1514] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Granulocytic sarcoma (GS) is an uncommon extramedullary tumor composed of dense aggregates of immature myeloid precursor cells, which is usually associated with acute or chronic myeloid leukemia. The tumor may also be a predecessor to acute myeloid leukemia (AML). It may be found in any location throughout the body; however, intraoral occurrence is extremely rare. This report describes a case of gingival granulocytic sarcoma that developed prior to AML in a 12-year-old female. METHODS AND RESULTS The patient, who had a 3-month history of gingival enlargement, was diagnosed as having granulocytic sarcoma based on clinical, radiological, and histological findings. Although the tumor regressed significantly after two induction chemotherapy courses, the patient subsequently died due to pneumococcal sepsis and pleurisy. CONCLUSION This case report affirms the importance of granulocytic sarcoma in the differential diagnosis of gingival enlargements, since the tumor may occur before bone marrow involvement by leukemic cells.
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Affiliation(s)
- B Antmen
- Cukurova University, Faculty of Medicine, Department of Pediatric Hematology/Oncology, Adana, Turkey
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Jordan RCK, Glenn L, Treseler PA, Regezi JA. Granulocytic sarcoma: case report with an unusual presentation and review of the literature. J Oral Maxillofac Surg 2002; 60:1206-11. [PMID: 12378502 DOI: 10.1053/joms.2002.35036] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Richard C K Jordan
- Department of Stomatology, University of California San Francisco, 94143, USA
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12
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Yamauchi K, Yasuda M. Comparison in treatments of nonleukemic granulocytic sarcoma: report of two cases and a review of 72 cases in the literature. Cancer 2002; 94:1739-46. [PMID: 11920536 DOI: 10.1002/cncr.10399] [Citation(s) in RCA: 239] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND The purpose of this study was to reveal the clinical characteristics of nonleukemic granulocytic sarcoma (GS) and an association between the therapeutic regimens and the nonleukemic period. METHOD Clinical records of 2 patients reported here and 72 patients gathered using a literature search on Medline from other institutions were analyzed. The patients consisted of 57 patients who preceded acute nonlymphoblastic leukemia (ANLL) and 17 patients who did not develop ANLL. These patients were divided into 3 groups by therapeutic regimens; Group I included 12 patients who received only biopsy or surgical resection of the tumor, Group II was 20 patients who received local irradiation for the tumor, and Group III consisted of 42 patients who received systemic chemotherapy. The nonleukemic periods between these groups were compared. In Group III, the period in the patients who were treated with chemotherapy given to ANLL was compared with that in the patients who received chemotherapy used for malignant lymphoproliferative disorders (MLPDs). RESULTS Thirty-five patients (47%) initially were misdiagnosed, and the disease was most often malignant lymphoma. Preferential sites of GS were the small intestine, mediastinum, epidural site, uterus, and ovary, which often are difficult for the detection and diagnosis in addition to the skin and lymph nodes known commonly. The nonleukemic period after the diagnosis of GS was significantly longer in Group III than in the other groups (median, 12 months in Group III vs. 3 and 6 months in Groups I and II, respectively). The aggressive chemotherapy given to ANLL led to a longer nonleukemic period than the chemotherapy used for MLPDs. CONCLUSIONS To reduce the risk of subsequent ANLL in patients with nonleukemic GS, it is important that accurate histologic diagnosis is established initially for GS and that all isolated cases of GS, even those that appear to be cured by resection or irradiation of the tumor, are treated with intensive chemotherapy similar to that used to treat ANLL during the nonleukemic period as soon as possible.
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Affiliation(s)
- Kunihiko Yamauchi
- Division of Rheumatology and Hematology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan.
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Tomás Carmona I, Cameselle Teijeiro J, Diz Dios P, Fernández Feijoo J, Limeres Posse J. Intra-alveolar granulocytic sarcoma developing after tooth extraction. Oral Oncol 2000; 36:491-4. [PMID: 10964059 DOI: 10.1016/s1368-8375(00)00024-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Granulocytic sarcoma (GS) is a malignant tumour composed of poorly differentiated myeloid cells forming in an extramedullary site. It is generally associated with acute leukaemia, particularly the myelocytic type. Its appearance in patients with chronic myeloid leukaemia is exceptional. GS can appear in multiple locations with the oral cavity being rarely involved. A mandibular GS detected in a patient with chronic myeloid leukaemia 10 days after a tooth extraction is reported. The pathogenesis (by metastatic cells or migration through the Haversian canals) of the tumour is discussed.
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Affiliation(s)
- I Tomás Carmona
- School of Medicine and Dentistry, Santiago de Compostela University, C./ Panamá 2; 2 degrees dcha, 36203, Vigo, Spain
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Tong AC, Lam KY. Granulocytic sarcoma presenting as an ulcerative mucogingival lesion: report of a case and review of the literature. J Oral Maxillofac Surg 2000; 58:1055-8. [PMID: 10981989 DOI: 10.1053/joms.2000.8752] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- A C Tong
- Department of Health, Queen Mary Hospital, Hong Kong.
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Affiliation(s)
- B C Stack
- University of South Florida, Department of Surgery-MDC016, Tampa 33682-0179
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Eisenberg E, Peters ES, Krutchkoff DJ. Granulocytic sarcoma (chloroma) of the gingiva: report of a case. J Oral Maxillofac Surg 1991; 49:1346-50. [PMID: 1955927 DOI: 10.1016/0278-2391(91)90317-f] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- E Eisenberg
- Department of Oral Diagnosis, University of Connecticut, Farmington 06030
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Cho JS, Kim EE, Ro JH, Pinkel DP, Goepfert H. Mandibular chloroma demonstrated by magnetic resonance imaging. Head Neck 1990; 12:507-11. [PMID: 2258291 DOI: 10.1002/hed.2880120611] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A case of chloroma or granulocytic sarcoma in the mandible of a young child is presented with magnetic resonance imaging (MRI) features.
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Affiliation(s)
- J S Cho
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston 77030
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Rodriguez JC, Arranz JS, Forcelledo MF. Isolated granulocytic sarcoma: report of a case in the oral cavity. J Oral Maxillofac Surg 1990; 48:748-52. [PMID: 2193130 DOI: 10.1016/0278-2391(90)90065-a] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Hicklin GA, Drevyanko TF. Primary granulocytic sarcoma presenting with pleural and pulmonary involvement. Chest 1988; 94:655-6. [PMID: 3165755 DOI: 10.1378/chest.94.3.655] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
A 36-year-old woman presented with cough, pleural effusion and atelectasis. Evaluation included pleural biopsy, bronchoscopy, bone marrow biopsy, endomyocardial biopsy and ultimately thoracotomy. The diagnosis of granulocytic sarcoma involving lungs and pleura but not bone marrow was made histologically.
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Affiliation(s)
- G A Hicklin
- Department of Medicine, Iowa Methodist Medical Center, Des Moines
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20
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Abstract
A chloroma is described in the left quadrant of the maxilla in a 4-year-old girl. This patient had previously completed a course of chemotherapy for acute myeloid leukaemia, but had been off all drug therapy and in remission for 1 year prior to presentation. Chloroma is a well recognised, if uncommon, mode of presentation of acute myeloblastic leukaemia and a previous case of chloroma occurring in the mandibular gingival tissues has been reported (Reichart et al., 1984). An unusual feature in the present case is the appearance of the chloroma as a form of leukaemic relapse and as a solitary deposit which is itself uncommon in acute myeloblastic leukaemia. It is suggested that this chloroma was a leukaemic deposit which had spread from within the maxillary antrum or the tissues adjacent to the meninges.
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Affiliation(s)
- G R Barker
- Department of Oral and Maxillofacial Surgery, Manchester University Dental School
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Ficarra G, Silverman S, Quivey JM, Hansen LS, Giannotti K. Granulocytic sarcoma (chloroma) of the oral cavity: a case with aleukemic presentation. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1987; 63:709-14. [PMID: 3473396 DOI: 10.1016/0030-4220(87)90375-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A case of granulocytic sarcoma, or chloroma, of the palatal mucosa, which developed 15 months before the onset of acute myelogenous leukemia (AML), is reported. The diagnosis was suspected on the basis of the light microscopic findings and confirmed by histochemical studies. Granulocytic sarcomas are rare, may be observed in a variety of body locations, and are considered specific lesions of AML or of the onset of blast crisis in chronic myelogenous leukemia. Primary granulocytic sarcomas of the oral cavity without systemic manifestations of AML are extremely rare. Clinical diagnosis of these lesions in patients with normal peripheral blood and bone marrow may be very difficult.
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Saleh MN, Rodu B, Prchal JT, de Leon ER. Acute myelofibrosis and multiple chloromas of the mandible and skin. Int J Oral Maxillofac Surg 1987; 16:108-11. [PMID: 3104488 DOI: 10.1016/s0901-5027(87)80039-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Acute myelofibrosis is a rare clinical entity characterized by severe marrow fibrosis and peripheral blood pancytopenia. It may be very closely related to and has been considered synonymous with megakaryocytic leukemia. Chloroma is also a rare entity composed of a localized collection of immature myeloid cells and is associated with a known or covert leukemia. A patient presenting with a rare combination of acute myelofibrosis, megakaryocytic leukemia and multiple chloromas of the mandible and skin, are described. Although presenting a diagnostic challenge, their combination in one patient aids in the understanding of the myeloproliferative process. To our knowledge, this is the 3rd case of chloroma involving the oral osseous structures.
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Abstract
Sixteen patients presenting with granulocytic sarcoma without evidence of acute leukemia were seen and diagnosed at The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston from 1962 to 1985. Seven of them (44%) did not develop acute leukemia. Of these seven, four are alive with no evidence of disease 3.5 to 16 years after initial presentation; the remaining three patients died of their disease within 2 to 8 months of presentation. Two of 16 patients were diagnosed within the last 15 months and do not have adequate follow-up. The seven remaining patients developed acute leukemia within 1 week to 13 months of the diagnosis of granulocytic sarcoma. Six of them died 5 weeks to 16 months after diagnosis; one patient has been in complete remission for 8 years. Twelve of these 16 cases (75%) were initially misdiagnosed, most frequently as large cell lymphoma. The remaining four cases were correctly diagnosed as granulocytic sarcoma. The naphthol-ASD-chloroacetate esterase stain was required to make the correct diagnosis in all cases. Contrary to findings in other series, granulocytic sarcoma arising in nonleukemic patients does not necessarily progress to acute leukemia. At least four of 16 (25%) patients in this series did not develop acute leukemia during the 3.5 to 16 years they have been followed. No prognostic factors were identified in this series to predict which patients would develop acute leukemia and which ones would not.
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Abstract
The case is presented of a 54-year-old black man with a mass apparently involving only the soft tissue retromolar trigone on panoramic and mandibular series radiographs. A granulocytic sarcoma involving the mandible was diagnosed on biopsy with the aid of histochemical stains, immunologic cell surface markers, and electron microscopy. The autopsy also revealed involvement of the ribs and liver.
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Epstein JB, Priddy RW, Sparling T, Wadsworth L. Oral manifestations in myelodysplastic syndrome. Review of the literature and report of a case. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1986; 61:466-70. [PMID: 3459123 DOI: 10.1016/0030-4220(86)90389-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Gingival hyperplasia in a patient with myelodysplastic syndrome is described. Gingival infiltration was the first sign of acceleration of a stable disease process and was followed by development of a more aggressive phase of chronic myelomonocytic leukemia that was not responsive to therapy. Oral and dental assessment of patients with the myelodysplastic syndromes should be a part of routine management.
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