Ömer Candar, Ömer Ekinci, Mustafa Merter, Mehmet Aslan, İlknur Çalık
Journal of Current Hematology & Oncology Research - 2025;3(4):100-102
Isolated myeloid sarcoma (MS) is a malignant neoplasm of myeloid origin that is located in extramedullary tissues. MS is rare; only 10-19% of MS cases originate from the gastrointestinal tract (GIT). These patients usually present with non-specific symptoms associated with the GIT, thus, the diagnosis is easily overlooked and patients are misdiagnosed. In this article, we present a case of isolated MS localized in the duodenal ampulla that presented with cholestatic jaundice. On magnetic resonance imaging (MRI) and MR cholangiography (MRCP), a 3.8x3.5 cm mass lesion was visualized in the duodenal ampulla. A diagnosis of MS was made based on an endoscopic retrograde cholangiopancreatography biopsy. It was recognized as an isolated MS after further examination. An idarubicin and cytarabine-based chemotherapy regimen was administered for induction and allogeneic HSCT was administered as post-remission consolidation therapy. The patient remains in remission under follow-up in the 6th month after allogeneic HSCT. Isolated MS is a rare hematologic neoplasia comprised of immature granulocytic cells. Although it can be detected in any part of the body, hepatobiliary, and particularly, pancreatic involvement is much less frequent. The optimal treatment of the disease is not elucidated due to the lack of relevant data and large prospective studies in the literature. The most recommended treatments are the systemic chemotherapies used in AML remission induction treatment. The authors think that HSCT must be considered after the induction of remission in MS, as it offers an advantage in terms of overall survival and leukemia-free survival.
