De novo myeloid sarcoma as a rare cause of small bowel obstruction: CT findings and histopathologic correlation

A Rare Case of Partial Small Bowel Obstruction Secondary to Intestinal Myeloid Sarcoma

This case report details a rare case of small bowel myeloid sarcoma (MS) in an otherwise fit and well 49-year-old male presenting initially with vague obstructive symptoms and weight loss. The patient ultimately required an operation for a small bowel obstruction where a laparotomy and small bowel resection were performed due to three cicatrising completely obstructing lesions in the mid-jejunum. Fewer than 1% of patients with acute myeloid leukaemia (AML) present with MS as an initial diagnosis, and only 6.5% of these are intestinal in origin. This report adds to the current body of literature on this rare condition, emphasises the diagnostic challenges resulting in delays to diagnosis, and discusses the crucial role of early and accurate identification for optimal treatment and prognosis. Surgery may be warranted in patients with complications such as obstruction; however, systemic chemotherapy tailored to AML is the primary therapeutic approach for MS patients.

Myeloid Sarcoma Presenting as Obstructive Jaundice

Myeloid sarcoma (MS) is a rare solid neoplasm that consists of extramedullary myeloid precursor cells. Generally, it is associated with underlying acute myeloid leukemia (AML) or AML yet to manifest clinically. It can present as isolated, also known as primary MS without evidence of AML or other myeloproliferative neoplasms. We present the case of a previously healthy 36-year-old male, who was admitted to hospital with new-onset painful obstructive jaundice and final diagnosis of isolated MS was made after through investigations. We are pleased to report that he had favorable response to the treatment and remains well.

Acute Myeloid Sarcoma: An Unusual Cause of Diarrhea

A 62-year-old man with a past medical history of hypothyroidism was admitted for diarrhea and abdominal pain for three weeks. Initial workup for diarrhea was negative. His condition deteriorated after hospitalization. He underwent sigmoidoscopy which showed rectosigmoid mucosal ulceration. Pathology showed leukemic cells infiltration of the mucosa. The patient underwent bone marrow biopsy which confirmed the diagnosis of acute myeloid leukemia (AML). He received induction chemotherapy and his symptoms improved.