Pelvic myeloid sarcoma: a multidisciplinary approach

Myeloid sarcoma (MS) is a rare tumor mass derived from the extramedullary proliferation of blasts of one or more of myeloid lineages. It usually occurs at an anatomical site other than the bone marrow (BM). Among the anatomical site which may be involved, female genital tract is a rare localization. When MS follows a previous history of myeloid pathology it is usually associated to a poor prognosis. To date this disease was managed with exploratory laparotomy or with surgical debulking. The authors report a case of laparoscopic diagnosis of a pelvic myeloid sarcoma in a patient previously affected by acute myeloid leukemia, evidencing the importance of minimally invasive diagnosis and subsequent multidisciplinary management.

Myeloid sarcoma; Laparoscopy; Multidisciplinary approach; Pelvic mass; Extramedullary sarcoma.

[1] Garcia M.G., Deavers M.T., Knoblock R.J., Chen W., Tsimberidou A.M., Manning J.T., Medeiros L.J.: “Myeloid sarcoma involving the gynecologic tract: a report of 11 cases and review of the literature”. Am. J. Clin. Pathol., 2006, 125, 783.

[2] Pitz M.W., Maslyak O., Morales C., Seftel M.D.: “Myeloid sarcoma of the uterus presenting as vaginal bleeding”. Intern. Med. J., 2006, 36, 669.

[3] Usmani S.Z., Shahid Z., Saleh H., Nasser K.A.: “Myeloid sarcoma presenting with acute renal failure and bilateral ureteral obstruction: a case report and review of the literature”. Am. J. Med. Sci., 2007, 334, 136.

[4] Yoshihara S., Ando T., Ogawa H.: “Extramedullary relapse of acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation: an easily overlooked but significant pattern of relapse”. Biol. Blood Marrow Transplant., 2012, 18, 1800.

[5] Medeiros L.R., Rosa D.D., Bozzetti M.C., Fachel J.M., Furness S., Garry R., et al.: “Laparoscopy versus laparotomy for benign ovarian tumour”. Cochrane Database Syst. Rev., 2009, 15.

[6] Harris A.C., Kitko C.L., Couriel D.R., Braun T.M., Choi S.W., Magenau J., et al.: “Extramedullary relapse of acute myeloid leukemia following allogenic hematopoietic stem cell transplantation: incidence, risk factors and outcomes”. Haematologica, 2006, 98, 179.

[7] Pavletic S.Z., Kumar S., Mohty M., De Lima M., Foran J.M., Pasquini M., et al.: “NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse after allogenic hematopoietic stem cell transplantation: report from the committee on the epidemiology and natural history of relapse following allogenic cell transplantation”. Biol. Blood Marrow Transplant., 2010, 16, 871.

[8] Padilla L.A., Radosevich D.M., Milad M.P.: “Limitations of the pelvic examination for evaluation of the female pelvic organs”. Int. J. Gynaecol. Obstet., 2005, 88, 84.

[9] Jung J.Y., Jung M.J., Oh J.Y., Kim M.H., Yun H.G., Oh L.Y., et al.: “Primary granulocytic sarcoma of ovary: A rare case report”. J. Womens Med., 2010, 3, 81.

[10] Avni B., Koren-Michowitz M.: “Myeloid sarcoma: current approach and therapeutic options”. Ther. Adv. Hematol., 2011, 2, 309.