Ignacio-Cconchoy Felipe L, Benites-Zapata Vicente A, Yanac-Avila Rommel L, Vela-Velàsquez César T
Internal Medicine Service, Hospital Nacional Alberto Sabogal Sologuren, Lima, Peru.
Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Lima, Peru.
Rep Pract Oncol Radiother. 2020 Mar-Apr;25(2):174-177. doi: 10.1016/j.rpor.2019.12.026. Epub 2020 Jan 9.
We describe a 35-year-old male patient showing a myeloid sarcoma (MS) of the tongue as the first manifestation of acute promyelocytic leukemia (APL). The MS can appear in all parts of the human body, but it is extremely rare in the tongue.
The main symptoms were a pain in the tongue, asthenia, gingivorrhagia, fever. We found a tumor in the tongue, which was irregular in size and located in the posterior region of the right lateral edge of the tongue. The diagnosis of MS was made by the anatomopathological and immunohistochemical study, while the definite diagnosis of APL was confirmed by the molecular test. The treatment of APL was based on the administration of trans-retinoic acid 45 mg/m daily continuously and daunorubicin 60 mg/m every other day for 4 doses, with a favorable therapeutic response to APL and MS.
Promyelocytic myeloid cells can infiltrate many organs extramedullary, such as the tongue, and this might precede bone marrow infiltration. The early identification of myeloid sarcoma allows to carry out an early treatment of the APL.
我们描述了一名35岁男性患者，其舌部髓系肉瘤（MS）为急性早幼粒细胞白血病（APL）的首发表现。MS可出现在人体的各个部位，但在舌部极为罕见。
主要症状为舌痛、乏力、牙龈出血、发热。我们在舌部发现一个肿瘤，大小不规则，位于舌右侧边缘后部。通过解剖病理学和免疫组织化学研究做出MS的诊断，而APL的确诊则通过分子检测。APL的治疗基于每日持续给予全反式维甲酸45mg/m²以及每隔一天给予柔红霉素60mg/m²共4剂，对APL和MS有良好的治疗反应。
早幼粒细胞可浸润许多髓外器官，如舌部，且这可能先于骨髓浸润。髓系肉瘤的早期识别有助于对APL进行早期治疗。
