Kuo C-L, Yu Y-B, Li W-Y, Lee Y-L
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
J Laryngol Otol. 2013 Apr;127(4):415-8. doi: 10.1017/S0022215113000285. Epub 2013 Feb 28.
We report a rare case of concurrent myeloid sarcoma and acute fulminant invasive fungal sinusitis in a patient with relapsed acute myeloid leukaemia.
A 73-year-old man was diagnosed with acute myeloid leukaemia and developed relapse one year later. After two courses of azacytidine, he began suffering from a dull pain in the left temporal and orbital regions. Sinus computed tomography showed a localised lesion in the left ethmoid sinus, which rapidly progressed to an extensive intracranial mass within one month. Surgical debridement was performed, and histopathological analysis revealed the coexistence of myeloid sarcoma and acute fulminant invasive fungal sinusitis. The patient responded well to prompt surgical debridement, antifungal medication and radiotherapy.
Coexistence of sinonasal myeloid sarcoma and acute fulminant invasive fungal sinusitis poses an urgent diagnostic and management challenge to clinicians. Timely recognition of this rare comorbid condition is warranted as application of appropriate treatment can save lives.
我们报告一例复发急性髓系白血病患者并发髓系肉瘤和急性暴发性侵袭性真菌性鼻窦炎的罕见病例。
一名73岁男性被诊断为急性髓系白血病，一年后病情复发。在接受两疗程阿扎胞苷治疗后，他开始出现左侧颞部和眶区隐痛。鼻窦计算机断层扫描显示左侧筛窦有一个局限性病变，在一个月内迅速发展为广泛的颅内肿块。进行了手术清创，组织病理学分析显示髓系肉瘤和急性暴发性侵袭性真菌性鼻窦炎并存。患者对及时的手术清创、抗真菌药物治疗和放疗反应良好。
鼻窦髓系肉瘤和急性暴发性侵袭性真菌性鼻窦炎并存给临床医生带来了紧迫的诊断和管理挑战。由于应用适当的治疗可挽救生命，因此有必要及时识别这种罕见的合并症。
