Myeloid Sarcoma of the Bladder in a Patient with Chronic myelomonocytic Leukaemia A Case report and Literature Review

Main Article Content

Rebecca Smith
Bashir Mohamed
Jeremy Nettleton


Myeloid sarcoma is a rare extramedullary tumour of immature granulocytes, most commonly involving the skin, bone, lymph nodes, and soft tissue. It is usually associated with a diagnosis of relapsed or de novo acute myeloid leukaemia, acute lymphoblastic transformation of a myelodysplastic/myeloproliferative neoplasm, or can occur as isolated myeloid sarcoma.
Case report
A 66-year-old female with a 7-year history of stable chronic myelomonocytic leukaemia presents with urgency, frequency, dysuria symptoms, and without new constitutional symptoms. She is found to have atypical, multifocal lesions on the right posterolateral wall of the bladder with associated hydronephrosis. Pathology reveals the diagnosis as myeloid sarcoma; surprisingly, bone marrow evaluation does not show evidence of acute leukaemic transformation.
Myeloid sarcoma occurring in patients with chronic myelomonocytic leukaemia is extremely rare, and there are no cases reported in the English literature of these patients developing lesions in the bladder. The urological manifestations of an underlying haematological malignancy are best managed with a combination of systemic chemotherapy and allogeneic stem cell transplant, and in this case, the only surgical intervention required was ureteric stenting and tissue biopsy. Although rare, it is essential to consider alternative diagnoses when confronted with an atypical bladder tumour; failure to do so may result in patient harm by exposure to unnecessary intervention and delay to potentially curative treatment.


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How to Cite
Smith, R., Mohamed, B., & Nettleton, J. (2022). Myeloid Sarcoma of the Bladder in a Patient with Chronic myelomonocytic Leukaemia: A Case report and Literature Review. Journal of Endoluminal Endourology, 4(3), e36-e43.
Case Reports
Author Biographies

Rebecca Smith, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, UK

Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, UK

Bashir Mohamed, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, UK

Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, UK

Jeremy Nettleton, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, UK

Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, UK


1. Swerdlow SH, Campo E, Harris NL, et al., editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Geneva, Switzerland: WHO Press; 2008.
2. Lazzarotto D, Candoni A, Filì C, et al. Clinical outcome of myeloid sarcoma in adult patients and effect of allogeneic stem cell transplantation. Results from a multicenter survey. Leuk Res. 2017;53:74–81. doi: 10.1016/j.leukres.2016.12.003
3. Wilson CS, Medeiros LJ. Extramedullary Manifestations of Myeloid Neoplasms. Am J Clin Pathol. 2015;144(2):219–239. doi: 10.1309/AJCPO58YWIBUBESX
4. Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization clas-sification of myeloid neoplasms and acute leuke-mia. Blood. 2016;127(20):2391–2405. doi: 10.1182/ blood-2016-03-643544. Epub 2016 Apr 11.
5. Patnaik MM, Tefferi A. Chronic Myelomonocytic leukemia: 2020 update on diagnosis, risk stratification and management. Am J Hematol. 2020;95(1):97–115. doi: 10.1002/ajh.25684. PMID: 31736132.
6. Hoversten K, Vallapureddy R, Lasho T, et al. Nonhepatosplenic extramedullary manifestations of chronic myelomonocytic leukemia: clinical, molecular and prognostic correlates. Leuk Lymphoma. 2018;59(12):2998–3001. doi: 10.1080/10428194.2018.1452212
7. John S, Ahmad HA, Dunn T, et al. Unusual presen-tation of bladder myeloid sarcoma causing acute renal failure: case report and review of the litera-ture. Clin Adv Hematol Oncol. 2013;11(6):388–393.
8. Geok Chin T, Masir N, Noor Hussin H, et al. Myeloid sarcoma of the urinary bladder with cutaneous tumour seeding after percutaneous suprapubic catheterization. Malays J Pathol. 2011;33(1):47–51.
9. Goh EH, Adel A, Singam P, et al. Myeloid sarcoma of the bladder: Case presentation and review of the literature. Urotoday Int J. 2011;4(5). doi: 10.3834/uij.1944-5784.2011.08.13
10. Sönmez M, Çobanoğlu Ü, Mungan S, et al. The association of bladder myeloid sarcoma and unclassified myelodysplastic/myeloproliferative disease. Turk J Haematol. 2009;26(2):90–92.
11. Al-Quran SZ, Olivares A, Lin P, et al. Myeloid sarcoma of the urinary bladder and epididymis as a primary manifestation of acute myeloid leukemia with inv(16). Arch Pathol Lab Med. 2006;130(6):862– 866. doi: 10.5858/2006-130-862-MSOTUB
12. Hasegeli Uner A, Altundag K, Saglam A, et al. Granulocytic sarcoma of the urinary bladder. Am J Hematol. 2004;75(4):262–3. doi: 10.1002/ ajh.20022
13. Aki H, Baslar Z, Uygun N, et al. Primary granulo-cytic sarcoma of the urinary bladder: case report and review of the literature. Urology. 2002;60(2):345. doi: 10.1016/s0090-4295(02)01750-8
14. Kerr P, Evely R, Pawade J. Bladder chloroma complicating refractory anaemia with excess of blasts. Br J Haematol. 2002;118(3):688. doi: 10.1046/j.1365-2141.2002.03653.x
15. Chaitin BA, Manning JT, Ordóñez NG. Hematologic neoplasms with initial manifestations in lower urinary tract. Urology. 1984;23(1):35–42.
16. Liu PI, Ishimaru T, McGregor DH, et al. Autopsy study of granulocytic sarcoma (chloroma) in patients with myelogenous leukemia, Hiroshima-Nagasaki 1949–1969. Cancer. 1973;31(4):948–955. doi: 10.1002/1097-0142(197304)31:4<948::aid-cn-cr2820310428>;2-n
17. Matanes F, AbdelAzeem BMA, Shah G, et al. Chronic myelomonocytic leukemia associated with myeloid sarcomas and NPM1 mutation: a case report and literature review. Ther Adv Hematol. 2019;10:2040620719854596. doi: 10.1177/2040620719854596. eCollection 2019
18. Nagra NS, Lozano E, Soilleux E, et al. A perianal presentation of myeloid sarcoma. BMJ Case Rep. 2015;2015. doi: 10.1136/bcr-2015-209832
19. Fukushima M, Ono Y, Imai Y. Granulocytic sarcoma of the small intestine in a patient with chronic myelomonocytic leukemia. Digest Endo. 2014;26(6):757–8. doi: 10.1111/den.12381
20. Craig JW, Lin RJ. Paraneoplastic autoimmu-nity associated with testicular myeloid sarcoma and chronic myelomonocytic leukemia. Case Rep Hematol. 2013;2013:656543. doi: 10.1155/2013/656543. Epub 2013 Oct 2.
21. Corcoran NM, Tsui A, Costello AJ, et al. Unilateral testicular mass in man with chronic myelomonocytic leukemia: Unusual presentation of chronic myelomonocytic leukemia sequela. Urology. 2005;65(5):1001. doi: 10.1016/j.urology.2004.11.041
22. Akiyama N, Ohwada A, Kajiwara K, et al. [Granulocytic sarcoma of the colon in chronic myelomonocytic leukemia]. Rinsho Ketsueki. 2002;43(10):937–942.
23. Yilmaz AF, Saydam G, Sahin F, et al. Granulocytic sarcoma: a systematic review. Am J Blood Res. 2013;3(4):265–270.
24. Almond LM, Charalampakis M, Ford SJ, et al. Myeloid sarcoma: presentation, diagnosis, and treatment. Clin Lymphoma Myeloma Leuk. 2017;17(5):263–267. doi: 10.1016/j.clml.2017.02.027. Epub 2017 Mar 7.