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

Published online by Cambridge University Press:  28 February 2013

C-L Kuo ,
Y-B Yu ,
W-Y Li  and
Y-L Lee
C-L Kuo
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan Department of Otorhinolaryngology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
Y-B Yu
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan
W-Y Li
Affiliation:
Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan
Y-L Lee*
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan
*
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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Abstract

Objective:

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.

Keywords

FungiParanasal SinusesSinusitisChloromaSarcoma, MyeloidLeukemia

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 4 , April 2013 , pp. 415 - 418
Copyright
Copyright © JLO (1984) Limited 2013

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