Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2024; 15(10): 1324-1332
Published online Oct 24, 2024. doi: 10.5306/wjco.v15.i10.1324
Cervical myeloid sarcoma as an initial clinical manifestation: Four case reports
Jin-Ke Li, Xiao-Xue Wang, Jia-Jun Fu, Dan-Dan Zhang
Jin-Ke Li, Dan-Dan Zhang, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Xiao-Xue Wang, Department of Health Management, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Jia-Jun Fu, Department of Pathology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Li JK wrote and edited the manuscript; Fu JJ and Wang XX collected the patients’ clinical data; Zhang DD conceptualized the paper and supervised its completion.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dan-Dan Zhang, Doctor, PhD, Associate Professor, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. zhangdd@sj-hospital.org
Received: March 23, 2024
Revised: August 26, 2024
Accepted: September 19, 2024
Published online: October 24, 2024
Processing time: 189 Days and 22.8 Hours
Abstract
BACKGROUND

Cervical myeloid sarcoma (MS) is a rare hematological malignancy characterized by the formation of extramedullary soft tissue masses in the cervical region. Due to its uncommon presentation in the female reproductive system, cervical MS poses significant diagnostic and therapeutic challenges. Consequently, there is a pressing need for more research and clinical experience to better understand, diagnose, and manage this condition effectively.

CASE SUMMARY

This report details four cases, the diagnostic process, treatment strategy, and outcomes, discussing cervical MS as an initial clinical manifestation. The disease exhibits varied clinical presentations, such as irregular vaginal bleeding and palpation of cervical masses. The treatment approaches discussed include neoadjuvant chemotherapy, surgery, and postoperative chemotherapy, though managing the disease remains challenging. The report also features a comprehensive literature review that underscores the importance of immunohistochemistry for accurate diagnosis, identifying key markers, including myeloperoxidase, cluster of differentiation (CD) 68, and CD43, stressing the need for further research to improve treatment strategies and prognosis.

CONCLUSION

Immunohistochemical diagnosis and tailored therapeutic strategies are essential. Further research is crucial in improving outcomes and developing effective treatment protocols.

Keywords: Cervical myeloid sarcoma; Hematologic malignancy; Clinical characteristics; Diagnosis; Treatment; Case report

Core Tip: Cervical myeloid sarcoma is rare but can indicate the presence of acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms. Immunohistochemistry is pivotal in diagnosing and differentiating myeloid sarcoma and the absence of cluster of differentiation (CD) 20 and CD3 can help distinguish it from lymphoma. Systemic chemotherapy is the most common treatment with some patients also undergoing surgery or radiation therapy. The literature indicates that allogeneic hematopoietic stem cell transplantation is a critical strategy for long-term survival.