Intraoral Myeloid Sarcoma with Bilateral Involvement – Case Report

Download Article

Athanasios Poulopoulos1 / Fotios Iordanidis2 / Dimitrios Andreadis1 / Konstantinos Antoniadis3

1Department of Oral Medicine & Oral Pathology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
2Gloucestershire Cellular Pathology Laboratory, Cheltenham General Hospital, Cheltenham, United Kingdom of Great Britain and Northern Ireland
3Department of Oral & Maxillofacial Surgery Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Summary

Background: Myeloid sarcoma (MS) is a solid malignant tumour associated with infiltration of immature myeloid precursor cells in an extramedullary site. The term MS has replaced the term granulocytic sarcoma and chloroma, which were used in the past. MS in the oral cavity is very uncommon, with less of 40 cases reported until recently. Case Report: We report the first case, the features, and the diagnostic sequence, of intraoral MS with bilateral palatal involvement, which presented as an initial manifestation, and preceded the appearance of acute myeloid leukaemia (AML). Diagnostic confirmation of such oral mucosal lesions usually requires biopsy, histopathological examination with additional immunohistochemical investigation. MS can occur during the course of acute or chronic myelogenous leukaemia, and myelodysplastic syndromes. In the vast majority of the reported cases, only one site was involved with a single intraoral MS lesion, and the cases predominantly associated with AML. Conclusion: The majority of intraoral MS occurs in patients with known AML, but in some of them, presented as an initial manifestation, and preceded the appearance of the disease. Therefore, clinicians should carefully evaluate all unusual oral lesions of unknown origin.

Keywords: Myeloid sarcoma; Granulocytic sarcoma; Chloroma; Acute myeloid leukaemia; Oral tumours

References

  1. Yap M, Hewson I, McLean C. Oral myeloid sarcoma: two case reports. Aust Dent J, 2014;59:511-515.[Web of Science][Crossref]
  2. Papamanthos KM, Kolokotronis EA, Skulakis EH, Fericean AAM, Zorba TM, Matiakis TA. Acute Myeloid Leukaemia Diagnosed by Intra-Oral Myeloid Sarcoma. A Case Report. Head and Neck Pathol, 2010;4:132-135.
  3. Xie Z, Zhang F, Song E, Ge W, Zhu F, Hu J. Intraoral granulocytic sarcoma presenting as multiple maxillary and mandibular masses: a case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007;103: e44-48.[Crossref]
  4. Tong AC, Lam KY. Granulocytic sarcoma presenting as an ulcerative mucogingival lesion: Report of a case and review of the literature. J Oral Maxillofac Surg, 2000;58:1055-1058.
  5. Carmona IT, Teijeiro JC, Dios PD, Feijoo JF, Posse JL. Intra-alveolar granulocytic sarcoma developing after tooth extraction. Oral Oncol, 2000;36:491-494.[Crossref]
  6. Colella G, Tirelli A, Capone R, Rubini C, Guastafierro S. Myeloid sarcoma occurring in the maxillary gingiva: a case without leukemic manifestations. Int J Hematol, 2005;81:138-141.[Crossref]
  7. Breccia M, Mandelli F, Petti MC, D’Andrea M, Pescarmona E, Pileri SA, Carmosino I, Russo E, De Fabritiis P, Alimena G. Clinico-pathological characteristics of myeloid sarcoma at diagnosis and during follow-up: report of 12 cases from a single institution. Leuk Res, 2004;28:1165-1169.[Crossref]
  8. Eisenberg E, Peters ES, Krutchkoff DJ. Granulocytic sarcoma (chloroma) of the gingiva: report of a case. J Oral Maxillofac Surg, 1991;49:1346-1350.
  9. Koudstaal MJ, van der Wal KGH, Lam KH, Meeuwis CA, Speleman L, Levin MD. Granulocytic sarcoma (chloroma) of the oral cavity: report of a case and literature review. Oral Oncol EXTRA, 2006;42:70-77.[Crossref]
  10. Jordan RC, Glenn L, Treseler PA, Regezi JA. Granulocytic sarcoma: case report with an unusual presentation and review of the literature. J Oral Maxillofac Surg, 2002;60:1206-1211.
  11. Osterne RLV, Matos-Brito RG, Alves APNN, Nogueira TNAG, Rocha-Filho FD, Meneses FA, Sousa FB. Oral granulocytic sarcoma: a case report. Med Oral Patol Oral Cir Bucal, 2009;14:e232-235.
  12. Brunning RD, Matutes E, Head D, Flandrin G, Harris NL, Vardiman J. Acute myeloid leukemia not otherwise categorised. In: Tumors of hematopoietic and lymphoid tissues edited by Jaffe ES, Stein H, Vardiman JW. Lyon: IARC Press, 2001; pp. 104-105.
  13. Lee SS, Kim HK, Choi SC, Lee JI. Granulocytic sarcoma occurring in the maxillary gingiva demonstrated by magnetic resonance imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2001;92:689-693.[Crossref]
  14. Srinivasan B, Ethunandan M, Anand R, Hussein K, Ilankovan V. Granulocytic sarcoma of the lips: report of an unusual case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008;105:e34-36.[Crossref]
Citation Information: Balkan Journal of Dental Medicine, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2017-0020. Export Citation

COMMENTS