Nonleukemic granulocytic sarcoma of orbit after blunt trauma

Abstract

Rationale: Granulocytic sarcoma without invasion of bone marrow or blood is very rare. The diagnosis of it is usually overlooked and the treatment has not reached a consensus. Meanwhile, the onset of this kind of disease is not clear. Patient concerns: Diagnose patients in early stage and help choose the right treatment strategies. Diagnoses: The ultimate diagnosis was nonleukemic granulocytic sarcoma after blunt trauma. Interventions: Surgery was the initial treatment option. Chemotherapy including idarubicin (70mg, D1-D3) and cytosine arabinoside (100mg, D1-D7) and radiotherapy of total 3,060cGy were then administered but failed to control the disease. Hematopoietic stem cell transplantation was finally administered. Outcomes: No evidence of disease progression or spread according to the latest follow-up. Lessons: The etiology of nonleukemic granulocytic still remains unclear, though trauma seems to be a potential predisposing factor and deserves more attention for early diagnosis and timely and proper treatment. Systemic chemotherapy is more effective than radiotherapy or surgery. Hematopoietic stem cell transplantation is an alternative choice after the failure of chemotherapy. Abbreviations: AML = Myelogenous leukemia, CML = Chronic myelogenous leukemia, CT = Computed tomography, EMT = Extramedullary myeloid cell sarcoma, GS = Granulocytic sarcoma, IHC = Immunohistochemistry, MPO = Myeloperoxidase, MRI = Magnetic resonance imaging.