Granulocytic sarcoma (chloroma) of the shoulder in Shwachman–Diamond syndrome

Shwachman–Diamond syndrome (SDS) is a rare congenital disorder characterized by exocrine pancreatic insufficiency, bone marrow dysfunction and chondrodysplastic skeletal anomalies including metaphyseal dysostosis. The major causes of morbidity and mortality are secondary to recurrent infection and susceptibility to leukemia. Allogeneic bone marrow transplantation (BMT) remains the standard treatment for bone marrow dysfunction and leukemia. We present the unusual case of a patient with SDS, status one-year post-BMT, who presented with a granulocytic sarcoma of the left shoulder, mimicking a septic arthritis.