Skip to main content
2024 ASCRS Annual Scientific Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
CME
CME
Invitation/Ticketed Event
Invitation/Ticketed Event
Invited Lectureship
Invited Lectureship
Award Recipient
Award Recipient
Live Streamed Session
Live Streamed Session
Nurses Contact Hours
Nurses Contact Hours
Self-Assessment
Self-Assessment
Back
ViewAttendees 1

Session: ePoster Monitor 5-Other Neoplasia and Endoscopy 3

eP680 - A Rare Case of Acute Myeloid Leukemia (AML) Presenting as a Necrotic Anal Mass

Monday, June 3, 2024
1:51 PM – 1:56 PM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Jonathan R. Pastrana Del Valle, MD (he/him/his)

    Fellow in Colorectal Surgery
    University of South Florida
    University of South Florida - Morsani College of Medicine
    Tampa, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • RB

    Robert D. Bennett, MD

    Assistant Professor of Surgery,
    University of South Florida
    Tampa, Florida, United States

    Disclosure information not submitted.

Purpose/Background: Acute myeloid leukemia (AML) is a myeloid neoplasm with an extremely variable clinical presentation. Extra medullary leukemic disease (EMD) is rare and is seen in 3–8% of adult patients with AML. EMD may precede, develop concurrently, or occur after therapy of AML, sometimes presenting as the initial feature. EMD – AML commonly afflicts lymph nodes and the spleen, with anal manifestations being exceptionally rare. The pathogenic mechanisms underlying EMD and risk factors are not precisely defined.Methods/Interventions: Case studyResults/Outcomes: A 62-year-old female presented with an 8-day history of rectal pain and was found to have an external perianal lesion on exam. Upon presentation she was febrile to 100.9 F with a heart rate of 111 beats per minute. Laboratory analysis was notable for WBC 3.67, with 73% blasts concerning for leukemia. Prior to surgery, the patient had a peripheral blood flow cytometry analysis which showed a myeloblast population of 63%, which was also positive for CD33, CD13, CD34, and showed partial positivity for MPO, HLA-DR, CD11b and CD11c. These histologic findings were consistent with acute myeloid leukemia. She then underwent an exam under anesthesia, excision and debridement of necrotic hemorrhoid tissue (perianal lesion) the subsequent day. On pathological examination the specimen was confirmed to have microscopic sections that demonstrated focally ulcerated squamous mucosa with marked superficial and deep infiltrate composed of large, atypical cells with fine chromatin, high nuclear-cytoplasmic ratio, and variably prominent nucleoli. These cells demonstrated positivity for MPO, CD34, and CD117 which was consistent with acute myeloid leukemia.Conclusion/

Discussion: After a search of the current literature, there have been no reported cases of extra medullary leukemic disease - acute myeloid leukemia presenting as a necrotic anal mass. Less than 5 cases have been published with perianal manifestations such as perianal abscess or fissures. Although it is very rare to see involvement of the anal canal in patients with acute myeloid leukemia, it is important to consider this manifestation as a possibility. Careful review of all pathology specimens, regardless of how benign they might initially seem on gross evaluation, is imperative in order to avoid misdiagnosis or inadequate treatment.