# Dysphagia as an Initial Presentation of Acute Myeloid Leukemia: A Rare Presentation of Myeloid Sarcoma

## TL;DR

A rare case of myeloid sarcoma presenting with swallowing difficulties was diagnosed as acute myeloid leukemia.

## Contribution

This case highlights a rare initial presentation of myeloid sarcoma with dysphagia and confirms AML through biopsy and imaging.

## Key findings

- The patient presented with dysphagia and generalized lymphadenopathy, confirmed by CT scans.
- Axillary lymph node biopsy confirmed myeloid sarcoma, and bone marrow biopsy showed AML with 88% blasts.
- The patient was treated with decitabine and venetoclax for four cycles over three months.

## Abstract

Myeloid sarcoma (MS) represents a unique clinical presentation of acute myeloid leukemia (AML). This report describes a case of MS in a 66-year-old man who presented with dysphagia, nausea, vomiting, anorexia, and fatigue. Generalized lymphadenopathy was noted on physical exam and confirmed by CT scans which also showed diffuse esophageal wall thickening. Axillary lymph node biopsy was positive for MS. Bone marrow biopsy confirmed AML with 88% blasts. The patient received induction chemotherapy with decitabine and venetoclax and was planned for four cycles of treatment over three months while monitoring the response.