H-Index
17
Scimago Lab
powered by Scopus
eISSN: 1941-5923
call: +1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Logo

MSMbanner
Medical Science Monitor Basic Research

Annals
ISI-Home

Peritoneal Myeloid Sarcoma in a Patient Treated for a Testicular Seminoma

Challenging differential diagnosis, Rare disease

Raffaele Longo, Véronique Dorvaux, Eric Chatelain, Philippe Quétin, Francesca Plastino, Nada Eid, Nathalie Marcon, Laurent Hennequin, Marco Campitiello

France Division of Medical Oncology, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France

Am J Case Rep 2018; 19:763-766

DOI: 10.12659/AJCR.910434

Available online:

Published: 2018-06-29


#910434

BACKGROUND: Myeloid sarcoma is a rare extramedullary soft tissue neoplasm composed of myeloblastic cells, usually associated to hematologic tumor disorders and a poor prognosis. Its diagnosis is very difficult as radiological images are not specific. Histology and immunohistochemistry are necessary for an accurate diagnosis.
CASE REPORT: We report the case of 46-year-old, Caucasian, non-smoker male, treated in 2014 by orchiectomy and systemic chemotherapy for a stage IIB testicular seminoma. Considering the rapid increase of lactate dehydrogenase (LDH) levels without any evident medical reason, a computed tomography/positron emission tomography (CT/PET) scan was performed and revealing a diffuse, nodular, peritoneal tumor infiltration associated with multiple mesenteric and mediastinal adenopathies. Laparoscopy confirmed a diffuse tumor infiltration of the peritoneum. Histology and immunohistochemistry were consisted with the diagnosis of a myeloid monoblastic sarcoma. Cytology of bone marrow documented an monocytic acute myeloid leukemia. The patient started a systemic induction chemotherapy with high dose cytarabine and idarubicin that was complicated by an infectious pneumonia and colitis, and a grade IV thrombocytopenia leading to a brain subdural hemorrhage and quickly to patient’s death.
CONCLUSIONS: We describe a rare, peritoneal, myeloid sarcoma in a young patient who had been treated by systemic chemotherapy for testicular seminoma 4 years earlier. The patient was clinically asymptomatic and presented only elevated LDH levels without any evident clinical reason. Considering the persistence of this biochemical abnormality, more investigations were performed leading to a diagnosis of peritoneal myeloid sarcoma associated with monocytic acute myeloid leukemia, probably secondary to the past chemotherapy.

Keywords: Leukemia, Myeloid, Acute, Sarcoma, Myeloid, Testicular Neoplasms



Back