Key result
Induction chemotherapy shrinks mediastinal myeloid sarcoma in a case of superior vena cava syndrome.
Why the study?
AML usually presents with non-specific features, but it may present with atypical clinical manifestations such as SVC syndrome, posing challenges in diagnosis and timely management.
Case Report (n=1)
This case highlights that acute myeloid leukemia can rarely present as superior vena cava syndrome due to a mediastinal myeloid sarcoma, requiring prompt diagnosis and multidisciplinary management.
Prompts vigilance for rare mediastinal myeloid sarcoma in AML with SVC syndrome; leaves open optimal management in larger cohorts.
Acute myeloid leukemia (AML) is the most prevalent form of leukemia in adults, with rising global incidence rates. AML usually presents with non-specific clinical features such as pallor, fever, and bleeding. This case report discusses a unique presentation of AML, where a 25-year-old female with a history of hypertension presented with unilateral facial swelling, chest pain, and shortness of breath. Radiologic investigations revealed a mediastinal mass encasing the superior vena cava (SVC), confirming the suspicion of SVC syndrome. Upon testing with a biopsy, the mass was found to be composed of immature myeloid cells confirming the diagnosis of myeloid sarcoma-associated AML. The patient's treatment involved a combination of surgical debridement, induction chemotherapy, supportive care, and management of complications. This case highlights that despite its common occurrence, AML may present with atypical clinical manifestations such as SVC syndrome, posing challenges in its diagnosis and timely management.
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Desai et al. (2023) conducted a case report in Acute Myeloid Leukemia with Superior Vena Cava Syndrome (n=1). Cytarabine and idarubicin induction chemotherapy was evaluated on Reduction in mediastinal mass dimensions. Induction chemotherapy with cytarabine and idarubicin reduced a mediastinal myeloid sarcoma from 6.6 x 6.2 x 7.0 cm to 5.1 x 5.5 cm in a 25-year-old female with acute myeloid leukemia presenting as superior vena cava syndrome.
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