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A 44 Year Old Man with Chronic Myeloid Leukemia and Mass at Right Lower Leg

ahadini islamiah, Shinta Oktya Wardhani
  Jurnal Kedokteran Brawijaya, Vol 29, No. 4 (2017),  pp.383-386  

Abstract


Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of primitive hematopoetic stem cells that is characterized by overproduction of myeloid series cells, splenomegaly, and leukocytosis. We reported a case of 44 years old male with CML who complained about swelling right leg and pain for 3 month. It had been diagnosed as CML for 3 years, and he took hydroxyurea but stopped for a year due to economic problem. The results of clinical examination, laboratory, biopsy, and radiology showed a result matched to CML with soft tissue mass. The results of Fine Needle Aspiration Biopsy (FNAB) of fragmented histiocytes leg mass, multinucleated giant cells, and atypical nucleated with a possibility of fibroma with atypical nucleated cells. Magnetic resonance imaging (MRI) showed multilocular lobulated soft tissue mass from the popliteal region to the cruris dextra, cyst mass high protein dd/solid tumor with vascular encasement and lesions in bone marrow replacement, and fluid collection on bursa parapatella. The patient was treated with hydroxyurea and showed clinical improvement and decreased mass size in the legs.


Keywords


Chronic myeloid leukemia, CML, hydroxyurea, mass leg

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References


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Cui Y, Liu T, Zhou Y, et al. Five Cases Report of Solid Tumor Synchronously with Hematologic Malignancy. Cancer Research and Treatment. 2012; 44(1): 63-68.

da Silva-Santos PS, Silva BS, Coracin FL, Yamamoto FP, Pinto-Junior DD, Magalhães MG. Granulocytic Sarcoma of the Oral Cavity in a Chronic Myeloid Leukemia Patient: An Unusual Presentation. Medicina Oral Patologia Oral y Cirugia Bucal. 2010; 15(2): e350-e352.

Horne SD, Stevens JB, Abdallah BY, et al. Why Imatinib Remains an Exception of Cancer Research. Journal of Cellular Physiology. 2013; 228(4): 665-670.

Jabbour E and Kantarjian H. Chronic Myeloid Leukemia: 2014 Update on Diagnosis, Monitoring, and Management. American Journal of Hematology. 2014; 89(5): 548-556.

Cohen M, Williams G, Johnson R, Duan J, Gobburu J, Rahman A, et al. Apprroval Summary for Imatinib Mesylate Capsules in the Treatment of Chronic Myelogenous Leukemia. Clinical Cancer Research. 2002; 8(5): 935-942.

Westin JR and Kurzrock R. It's About Time: Lessons for Solid Tumors from Chronic Myelogenous Leukemia Therapy. Molecular Cancer Therapeutics. 2012; 11(12): 2549-2555.

Jenkins CI and Sorour Y. Case Report : A Large Extramedullary Granulocytic Sarcoma as the Initial Presenting Feature of Chronic Myeloid Leukemia. Medscape General Medicine. 2005; 7 (4): 23.

Druker B, Guilhot F, O'Brien S, et al. Five-Year Follow-up of Patients Receiving Imatinib for Chronic Myeloid Leukimia. The New England Journal medicine. 2006; 355(12): 2408-2417.


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