Sarcoma mieloide de intestino delgado en paciente aleucémico

A 19 year-old man with a clinical suspicion of Crohn's disease underwent surgery for intestinal occlusion in the distal jejunum. Macroscopically, a mass infiltrating the intestinal wall and adjacent mesenteric fat was seen. Histologically, the intestinal wall was infiltrated by poorly differentiated cells which were positive for myeloperoxidase and a diagnosis of myeloid sarcoma was made. No evidence of bone marrow involvement or myelodysplastic or myeloproliferative disorders was seen. The patient was treated with chemotherapy and, after several complications which were successfully resolved, is asymptomatic 2 years after the initial diagnosis. This unusual case of a rare tumour, occurring in the intestine in the absence of previous haematological malignancy, draws attention to the diagnostic difficulties involved; indeed, 75% of nonleukemic cases are initially misdiagnosed, often being confused with poorly differentiated malignant tumours.