De Novo Myeloid Sarcoma of the Kidney: A Case Report and Literature Review of Clinical Features and Outcomes

Myeloid sarcoma (MS) can manifest as a primary disease entity, known as de novo myeloid sarcoma, without the concurrent presence of acute or chronic myelocytic leukemia, myelodysplastic syndrome, or myeloproliferative neoplasm. It is crucial to approach suspected de novo myeloid sarcoma cases comprehensively to prevent misdiagnosis and ensure timely and accurate treatment. We report a case of de novo myeloid sarcoma involving the kidney in a 38-year-old female patient with a chief complaint of a rapidly enlarging palpable mass in the upper right quadrant for over a month. The patient's enhanced abdominal CT scan result was initially suspected to be renal cell carcinoma. Subsequently, we performed radical nephrectomy and post-operative pathology, immunohistochemistry, and cytogenetic analysis to confirm the diagnosis of de novo myeloid sarcoma. Histopathological analysis confirmed malignancy originating from the right kidney, accompanied by necrosis. The tumor cells displayed moderate size, evident pleomorphism, and off-centered granular cytoplasm. Extensive infiltration of the renal parenchyma was observed, involving the renal capsule, perirenal adipose tissue, and renal pelvis mucosa. CD117 displayed positive immunohistochemical staining. There is currently a dearth of studies that comprehensively describe de novo myeloid sarcoma involving the urogenital tract. In light of this gap in the literature, the present study aims to provide a systematic literature review and present a case of de novo myeloid sarcoma involving the kidney in patients with normal bone marrow biopsy. Our objective is to elucidate the clinical presentation and prognosis of de novo myeloid sarcoma involving the urogenital tract, thereby contributing to the existing knowledge base, and facilitating evidence-based treatment decisions. The multifaceted nature of MS necessitates a multidisciplinary approach, including thorough diagnostic evaluation involving immunohistochemistry, cytochemistry, and cytogenetic analysis. Standardizing terminology and refining diagnostic and treatment algorithms through future prospective studies are vital steps toward enhancing clinical management and prognosis for patients with de novo myeloid sarcoma of the urogenital tract.