Cervical Granulocytic Sarcoma Without Acute Leukemia: A Case Report and Review of 42 Additional Cases

Granulocytic sarcoma (GS), also known as extramedullary myeloid tumor, is a rare malignant neoplasm composed of immature myeloid cells. Although it is most commonly associated with acute myeloid leukemia (AML), a subset of GS cases can occur prior to the development of AML. GS can present in a variety of extramedullary locations, including bone, skin, lymph nodes, and the female reproductive system. We report the case of a 45-year-old Asian female patient who presented to our hospital in July 2015 with a three-month history of left-sided lumbago. A contrast-enhanced computed tomography (CT) scan of the abdomen and pelvis revealed a retroperitoneal mass and an enlarged uterine cervix with an accompanying 57×52 mm mass. A cervical biopsy confirmed the diagnosis of GS. Immunohistochemical (IHC) analysis of the biopsy showed that the neoplastic cells were positive for CD34, CD15, CD33, CD43, lysozyme, and myeloperoxidase. The patient was subsequently treated with an idarubicin and cytarabine-based regimen for four cycles. A follow-up CT scan of the abdomen and pelvis demonstrated a significant reduction in the size of the previous lesions. Unfortunately, the patient passed away in April 2016 due to a cerebral hemorrhage. In this report, we also review 42 additional cases to discuss the pathological characteristics, treatment strategies, and clinical outcomes of GS.