Myeloid sarcoma is described as
tumor mass consisting of myeloblasts or immature myeloid cells, involving extramedullary tissues. It can be initial manifestation of
myeloproliferative disorders or relapse of previously treated
acute myeloblastic leukemia (AML). We present two patients, one with AML-M2 and the other with
acute promyelocytic leukemia (APL)-M3. After remission induced by conventional
chemotherapy, which continued for 3 and 10 years respectively, a
myeloid sarcoma was diagnosed. Biopsy of a retroauricular
tumor formation was made in the first case. The second one was diagnozed after biopsy of a supraclavicular lymph node. In both cases complete laboratory investigation including blood smear, differential counting and flow cytometric analysis of bone marrow were normal. Despite this, the patients received
chemotherapy. The APL-M3 patient was treated with
radiotherapy to the involved supraclavicular lymph node which was followed by
chemotherapy. Three months after
radiotherapy bone marrow infiltration and blast cells in the peripheral blood were found. Two years after the diagnosis of
myeloid sarcoma the patient died of haemorrhagic
stroke. The patient with AML-M2 continued treatment with
polychemotherapy.