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Unusual coexistence of sinonasal myeloid sarcoma and acute fulminant invasive fungal sinusitis: a diagnostic dilemma

  • C-L Kuo (a1) (a2), Y-B Yu (a3), W-Y Li (a4) and Y-L Lee (a1)
Abstract
AbstractObjective:

We report a rare case of concurrent myeloid sarcoma and acute fulminant invasive fungal sinusitis in a patient with relapsed acute myeloid leukaemia.

Case report:

A 73-year-old man was diagnosed with acute myeloid leukaemia and developed relapse one year later. After two courses of azacytidine, he began suffering from a dull pain in the left temporal and orbital regions. Sinus computed tomography showed a localised lesion in the left ethmoid sinus, which rapidly progressed to an extensive intracranial mass within one month. Surgical debridement was performed, and histopathological analysis revealed the coexistence of myeloid sarcoma and acute fulminant invasive fungal sinusitis. The patient responded well to prompt surgical debridement, antifungal medication and radiotherapy.

Conclusion:

Coexistence of sinonasal myeloid sarcoma and acute fulminant invasive fungal sinusitis poses an urgent diagnostic and management challenge to clinicians. Timely recognition of this rare comorbid condition is warranted as application of appropriate treatment can save lives.

Copyright
Corresponding author
Address for correspondence: Dr Yi-Lun Lee, Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital and National Yang-Ming University, No 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan Fax: +886 2 2875 5715 E-mails: drtgud@gmail.com; allenlee0730@gmail.com
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1JH Jo , HS Chi , KJ Cho . Granulocytic sarcoma of the maxillary sinus. A case report. Basic Appl Pathol 2009;2:72–4

2SA Pileri , S Ascani , MC Cox , C Campidelli , F Bacci , M Piccioli Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia 2007;21:340–50

4RS Neiman , M Barcos , C Berard , H Bonner , R Mann , RE Rydell Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer 1981;48:1426–37

7JA Sarvis , BK Auge . Myeloid (granulocytic) sarcoma of epididymis as rare manifestation of recurrent acute myelogenous leukemia. Urology 2009;73:1163.e1–3

8VA Epstein , RC Kern . Invasive fungal sinusitis and complications of rhinosinusitis. Otolaryngol Clin North Am 2008;41:497524

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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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