文献类型：期刊文献

英文题名：Case Report: Iliac perivascular myeloid sarcoma presenting with iliofemoral deep vein thrombosis and hydronephrosis

作者：Shan, Zhao[1];Wang, Yue[1];Wang, Honggang[2];He, Jiaxuan[3];Cai, Hongyi[1]

第一作者：Shan, Zhao

通信作者：Cai, HY[1]

机构：[1]Gansu Univ Chinese Med, Gansu Prov Hosp, Clin Med Coll 1, Dept Radiat Oncol, Lanzhou, Peoples R China;[2]Dongguan Taixin Hosp, Dept Radiat Oncol, Dongguan, Peoples R China;[3]Wuwei Peoples Hosp, Dept Ultrasound Diag, Wuwei, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Gansu Prov Hosp, Clin Med Coll 1, Dept Radiat Oncol, Lanzhou, Peoples R China.|[10735]甘肃中医药大学;

年份：2026

卷号：16

外文期刊名：FRONTIERS IN ONCOLOGY

收录：;Scopus(收录号：2-s2.0-105040954660);WOS:【SCI-EXPANDED(收录号:WOS:001772405700001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. This work was supported by the Major Project of Gansu Provincial Joint Research Fund, "Construction of an organoid-based predictive system for precision radiotherapy of digestive system tumors" (Grant No. 25JRRA1196).

语种：英文

外文关键词：acute myeloid leukemia; deep vein thrombosis; myeloid sarcoma; PET/CT; venetoclax

摘要：Myeloid sarcoma (MS) is a rare extramedullary tumor of myeloid blasts that may occur before, concurrently with, or after acute myeloid leukemia (AML) (1-4). We report a 53-year-old man with progressive left lower-limb pain and swelling, initially admitted to the vascular surgery service, with imaging revealing left external iliac vein and proximal common femoral vein occlusive thrombosis, a peri-iliac mass encasing the iliac vessels, and ipsilateral hydronephrosis. Biopsy of the left inguinal lesion showed MPO positivity, CD34 positivity, partial TdT positivity, and a Ki-67 index of about 80%, supporting myeloid sarcoma. Bone marrow studies confirmed AML with maturation, with 55% blasts, a myeloid immunophenotype, CEBPA (TAD1) positivity, and a complex karyotype. Baseline fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) demonstrated irregular perivascular soft tissue extending from the left common to external iliac vessels, with mild FDG uptake. The patient received AML-directed therapy, including two IA cycles and high-dose cytarabine, achieving morphologic complete remission with a marked PET/CT response. During follow-up, measurable residual disease (MRD) fluctuated repeatedly despite continued morphologic remission, prompting venetoclax-based therapy, including cytarabine plus venetoclax, azacitidine plus venetoclax with homoharringtonine, and later azacitidine plus venetoclax combined with tislelizumab. At the last follow-up in December 2025, the patient remained alive. This case highlights that peri-iliac MS may mimic vascular and urologic disease and that serial MRD monitoring can be useful for guiding postremission treatment adaptation in AML with extramedullary disease.