Atypical Presentation of Myeloid Sarcoma Mimicking a Subcutaneous Hematoma as Complication of MDS and AML

Abstract

Introduction: Less than 1% of patients with CML or acute leukemia transformations of other chronic disorders such as myeloproliferative neoplasms, particularly myelofibrosis, will present with and extramedullary presentation. Sites of isolated myeloid sarcoma include bone, periosteum, soft tissues, and lymph nodes, and less commonly the orbit, intestine, mediastinum, epidural region, uterus, and ovary. Methods: We conducted a systematic review of cases reported in the literature since 2005 to 2013. We identified similar cases to the actual ones that presented to our practice. The patients were diagnosed with myeloid sarcoma with an atypical presentation as a hematoma. We described 2 case reports, both have an atypical presentation of myeloid sarcoma mimicking a hematoma in different parts of the body. Results: We found in the literature a total of 4 cases with myeloid sarcoma with an atypical presentation as a hematoma. About, 3 of them (n=3, 75%) reported subdural hematomas. Only 1 case (n=1, 25%) reported an ocular involvement/retro-orbital hematoma. We present 2 cases that presented to our practice with a diagnosis of myeloid sarcoma and later on complicated as a subcutaneous hematoma. Discussion: We analyzed the fact that myeloid sarcoma has a very unusual presentation as a hematoma. The review of the literature supports this fact. However this should make as aware that even though this is an unusual and unique presentation we should think about it and always test the biopsy sample for IHC and flow cytometry in order to later on diagnose and treat