Leucemia mieloide aguda: Sarcoma granulocítico retroorbitario y mucormicosis rinomaxilar

1998 
espanolDescribimos un caso de mucormicosis rinomaxilar y sarcoma granulocitico retroorbital en el curso de una leucemia mieloide aguda. Tras el tratamiento con poliquimioterapia de un paciente de un ano de edad afecto de leucemia mieloide aguda, este desarrollo una neutropenia inducida farmacologicamente presentando escaras necroticas en fosas nasales y paladar. El estudio histologico confirmo el diagnostico de mucormicosis. La TC sugeria afectacion nasal y maxilar, sin extension orbitaria ni encefalica. Se procedio a cirugia (debridamiento extenso incluyendo maxilectomia parcial), tratamiento de soporte y anfotericina B liposomial, con curso satisfactorio. Tras ello, el paciente desarrollo un tumor en esfenoides izquierdo compuesto de precursores granulociticos, coincidiendo con un empeoramiento sistemico y fallecio. EnglishThis report describes a case of rhinomaxillary mucormycosis and retroorbital granulocytic sarcoma in the course of an acute myeloid leukemia. A one year old boy with acute myeloid leukemia was treated with combination chemotherapy. The patient had severe druginduced neutropenia when a necrotic eschar developed in the region of the internal nose and palate. Mucormycosis was identified by histology. CT findings suggested involvement of the nose and maxilla, without affecting orbit and brain. The patient was successfully treated by a combination of surgery (extensive debridement including partial maxillectomy), supportive therapy and liposomal amphotericin B. Then the patient developed an extramedullary tumor in the left sphenoid ridge composed of granulocytic precursor cells and concomitantly with a sistemic worsening and he subsequently died.
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