ISOLATED BONE MASS: GRANULOSITIC COULD IT BE SARCOMA?

Abstract

Introduction: Granulocytic sarcoma (GS) is a localized tumor arising from extramedullary invasion of granulocytic precursor cells and is also called chloroma, monocytic sarcoma, myeloid sarcoma, myeloblastoma, extramedullary myeloid cell tumor in the literature. It is usually localized in bone, periosteum, soft tissue, lymph nodes or skin. The paranasal sinuses and orbit are most commonly affected.GS is also a rare initial presentation of acute myeloid leukemia. Case report: In this case, we report a 2 years and 10 months old female patient who presented with leg pain and upper respiratory tract infection. Because of the absence of blasts in the peripheral blood fingertip smear and bone marrow aspiration, AML was not considered and GS was diagnosed with a delayed delay, which was then successfully treated with intensive chemotherapy. Conclusion: In the presence of extramedullary mass in children, should be investigated with detailed examination and imaging methods. The possibility of acute leukemia should also be kept in mind. In this case report, we present a rare case of granulocytic sarcoma causing destriction of the thoracic costa.

Keywords

• acute myeloid leukemia
• granulocytic sarcoma
• myeloproliferative disease
• child

İZOLE KEMİK KİTLESİ: GRANÜLOSİTİK SARKOM OLABİLİR Mİ?

Öz

Giriş: Granülositik sarkom (GS) granülositik prekürsör hücrelerin ekstramedüller yayılımından kaynaklanan lokalize bir tümördür ve literatürde; chloroma, monositik sarkom, myeloid sarkom, myeloblastom, ekstramedüller myeloid hücreli tümör olarak da adlandırılmaktadır. Genellikle kemik, periost, yumuşak doku, lenf nodları veya deride lokalize olur. En yaygın paranazal sinüsler ve orbita etkilenir. GS ayrıca akut miyeloid löseminin nadir bir başlangıç prezentasyonudur. Olgu: Bu olgumuzda bacak ağrısı ve üst solunum yolu enfeksiyonu bulgularıyla başvuran 2 yaş 10 aylık kız hasta sunulmaktadır. Hastamıza yapılan periferik kandan parmak ucu yaymasında ve kemik iliği aspirasyonunda blast görülmemesi nedeniyle akut miyeloid lösemi (AML) düşünülmeyip gecikerek GS tanısı alan, daha sonra yoğun kemoterapi ile başarılı şekilde tedavisi devam eden bir olgu sunulmaktadır. Sonuç: Çocuklarda ekstramedüller kitle varlığında ayrıntılı muayene ve görüntüleme yöntemleri ile araştırılmalıdır. Akut lösemi tablosu ihtimali de akılda tutulmalıdır. Bu olgu sunumunda, torasik kostada destrüksiyona neden olan nadir bir granülositik sarkom olgusu sunulmuştur.

Anahtar Kelimeler

• akut miyeloid lösemi
• granülositik sarkom
• miyeloproliferatif hastalık
• çocuk

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