Surgical Colonic Myeloid Sarcoma Following Bone Marrow Transplantation in a Patient With Acute Myeloid Leukemia With Myelodysplasia-Related Changes: A Case Report

TL;DR

A rare case of colonic myeloid sarcoma following a bone marrow transplant in a patient with leukemia is reported, highlighting its diagnostic challenges and aggressive progression.

Contribution

This is the first reported surgical case of colonic myeloid sarcoma causing bowel obstruction without intestinal perforation.

Findings

Colonic myeloid sarcoma can present as bowel obstruction and requires surgical intervention.

The disease can progress aggressively to multiple organs despite treatment.

Diagnosis is challenging due to varied radiological findings.

Abstract

Myeloid sarcoma (MS), a rare extramedullary manifestation of acute myeloid leukemia, can develop in various anatomical sites, including the skin, lymph nodes, and bones. Gastrointestinal involvement is uncommon, and colonic MS is particularly rare. We describe the case of a 60-year-old man with a history of acute myeloid leukemia with myelodysplasia-related changes who underwent bone marrow transplantation. He presented with diarrhea, and abdominal computed tomography revealed bowel obstruction caused by a large ascending colon mass with associated lymphadenopathy. Emergency surgery was performed, and histopathological examination confirmed the diagnosis of colonic MS. One year and 6 months after surgery, leukemic infiltration was detected in multiple organs, including spinal cord, cerebellum, and bone marrow, on positron emission tomography-computed tomography. The patient died about 4 years after the initial presentation. This was the first surgical case of colonic MS caused by bowel obstruction without intestinal perforation. Diagnosis of colonic MS is difficult because of its various radiological findings; however, it may follow as aggressive clinical course, in as our case. This case highlights the radiological and clinical characteristics of surgically managed colonic MS cases in literature.

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