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Keywords

Myeloid Sarcoma, Acute Myeloid Leukemia, Eosinophilia, Buccal Mucosa

Abstract

Myeloid sarcoma is a rare extramedullary presentation of acute myeloid leukemia and is especially uncommon in the oral cavity. The presence of myeloid sarcoma may be the initial manifestation of an underlying hematolymphoid disorder or may indicate relapsing disease. We report a case of a 48-year-old male with refractory acute myeloid leukemia who presented with a painful, yellow, plaque-like ulceration on the buccal mucosa. Incisional biopsy demonstrated ulcerated squamous mucosa with a dense infiltrate of large, atypical immunoblastic cells admixed with a prominent population of morphologically atypical eosinophils. These findings were consistent with myeloid sarcoma in the context of the patient’s known disease. The patient subsequently underwent an allogeneic hematopoietic stem cell transplant but ultimately died of disease six months later. This case highlights the diagnostic challenges associated with myeloid sarcoma and the importance of integrating clinicopathologic features with immunophenotypic and molecular findings to achieve an accurate diagnosis and guide timely management.

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