Rare primary bilateral ovarian myeloid sarcoma preceding acute myeloid leukemia: ovarian-sparing management with long-term ovarian function and pregnancy after allogeneic hematopoietic stem cell transplantation-a case report.
- 1Department of Obstetrics & Gynaecology and Minimal Invasive Gynaecology, ILS Hospitals, Kolkata, West Bengal, India (Tantia and Majumdar).
- 2Department of Minimal Access Surgery, ILS Hospitals, Kolkata, West Bengal, India (Khanna).
- 3Department of Pathology, ILS Hospitals, Kolkata, West Bengal, India (Kapoor).
Abstract
Myeloid sarcoma is a rare extramedullary manifestation of acute myeloid leukemia (AML) that may mimic benign gynecologic disease and delay diagnosis. Ovarian involvement is particularly uncommon, with bilateral disease rarely reported. We describe a 24-year-old nulliparous woman presenting with dysmenorrhea, chronic pelvic pain and bilateral adnexal masses suggestive of endometrioma on ultrasonography. Laparoscopy demonstrated bilaterally enlarged predominantly solid ovaries inconsistent with the preoperative diagnosis. Fertility-conserving surgery with unilateral salpingo-oophorectomy and contralateral ovarian conservation was performed because of the patient's young age, reproductive goals and uncertain diagnosis. Histopathology and immunohistochemistry confirmed myeloid sarcoma with variable membranous positive for CD45 and strong positivity for myeloperoxidase, and CD117. Initial peripheral blood smear was normal; however, AML with t(8;21) and RUNX1-RUNX1T1 fusion developed 50 days later. The patient subsequently underwent cytarabine-based chemotherapy followed by allogeneic hematopoietic stem cell transplantation. At 60-month follow-up, she remains in complete remission with restoration of ovarian function, evidenced by regular menstrual cycles and normal anti-Müllerian hormone levels. She subsequently underwent in vitro fertilization using her own eggs and successfully conceived. This case highlights the diagnostic limitations of imaging for atypical ovarian masses, the importance of intraoperative reassessment, and that individualized fertility-conserving management may achieve favorable oncologic and reproductive outcomes in selected young women.
Related
- The role of allogeneic hematopoietic stem cell transplantation in adults with mature T‐cell lymphomas
- Case Report: SAPHO syndrome mimicking osseous relapse after haploidentical allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia
- Viral Respiratory Infections Diagnosed by Multiplex PCR after Allogeneic Hematopoietic Stem Cell Transplantation: Long-Term Incidence and Outcome
- Secondary Pulmonary Alveolar Proteinosis after Allogeneic Hematopoietic Stem Cell Transplantation in the Setting of an Respiratory Syncytial Virus Infection: A Case Report
- TP53-mutated Therapy-related Leukemia with the Der(5;17)(p10;q10) Chromosomal Abnormality Following Chemotherapy for Acute Promyelocytic Leukemia Bridged to Allogeneic Hematopoietic Stem Cell Transplantation Using CPX-351
BibTeX
@article{tantia2026rare,
title = {{Rare primary bilateral ovarian myeloid sarcoma preceding acute myeloid leukemia: ovarian-sparing management with long-term ovarian function and pregnancy after allogeneic hematopoietic stem cell transplantation-a case report.}},
author = {Aruna Tantia and Shashi Khanna and Poonam Kapoor and Kajari Majumdar},
journal = {AJOG global reports},
year = {2026},
month = oct,
doi = {10.1016/j.xagr.2026.100706},
url = {https://europepmc.org/article/MED/42997612},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Rare primary bilateral ovarian myeloid sarcoma preceding acute myeloid leukemia: ovarian-sparing management with long-term ovarian function and pregnancy after allogeneic hematopoietic stem cell transplantation-a case report.
AU - Aruna Tantia
AU - Shashi Khanna
AU - Poonam Kapoor
AU - Kajari Majumdar
PY - 2026
DA - 2026/10/07
JO - AJOG global reports
DO - 10.1016/j.xagr.2026.100706
UR - https://europepmc.org/article/MED/42997612
AB - Myeloid sarcoma is a rare extramedullary manifestation of acute myeloid leukemia (AML) that may mimic benign gynecologic disease and delay diagnosis. Ovarian involvement is particularly uncommon, with bilateral disease rarely reported. We describe a 24-year-old nulliparous woman presenting with dysmenorrhea, chronic pelvic pain and bilateral adnexal masses suggestive of endometrioma on ultrasonography. Laparoscopy demonstrated bilaterally enlarged predominantly solid ovaries inconsistent with the preoperative diagnosis. Fertility-conserving surgery with unilateral salpingo-oophorectomy and contralateral ovarian conservation was performed because of the patient's young age, reproductive goals and uncertain diagnosis. Histopathology and immunohistochemistry confirmed myeloid sarcoma with variable membranous positive for CD45 and strong positivity for myeloperoxidase, and CD117. Initial peripheral blood smear was normal; however, AML with t(8;21) and RUNX1-RUNX1T1 fusion developed 50 days later. The patient subsequently underwent cytarabine-based chemotherapy followed by allogeneic hematopoietic stem cell transplantation. At 60-month follow-up, she remains in complete remission with restoration of ovarian function, evidenced by regular menstrual cycles and normal anti-Müllerian hormone levels. She subsequently underwent in vitro fertilization using her own eggs and successfully conceived. This case highlights the diagnostic limitations of imaging for atypical ovarian masses, the importance of intraoperative reassessment, and that individualized fertility-conserving management may achieve favorable oncologic and reproductive outcomes in selected young women.
SN - 2666-5778
ER -