Small-bowel myeloid sarcoma: Report of a case with atypical presentation

Autor: Giovanni Serio, Carlo M. Girelli, Marilù Latargia, Alessandra Aguzzi, Valentina Carsenzuola
Rok vydání: 2014
Předmět:
Zdroj: International Journal of Surgery Case Reports
ISSN: 2210-2612
Popis: INTRODUCTIONSmall-bowel myeloid sarcoma is rare. Acute bowel obstruction is its usual clinical presentation.PRESENTATION OF CASEWe report a case of small-bowel myeloid sarcoma that occurred in a 64-year-old woman who presented chronic secretory diarrhoea, hypokalaemia, and weight loss. Immature white blood cells in a peripheral smear and small-bowel capsule endoscopic features were the main diagnostic clues. The patient experienced capsule retention and developed acute bowel obstruction. Urgent laparotomy showed a stricturing ileal mass and pathology of the resected bowel specimen unveiled a CD34+, CD117+, and myeloperoxidase-positive myeloid sarcoma. The diarrhoea promptly resolved after surgery, and the patient is now undergoing chemotherapy.DISCUSSIONSecretory diarrhoea can be the first manifestation of small-bowel myeloid sarcoma. Capsule endoscopy may provide a diagnostic clue, but it can trigger an acute bowel obstruction. Differential diagnosis of the pathologic specimen may be difficult and a high suspicion index of is mandatory to perform immunophenotyping to determine the correct management.CONCLUSIONChronic diarrhoea with alarm features can be the first manifestation of small-bowel myeloid sarcoma.
Databáze: OpenAIRE