Unusual presentation of bladder myeloid sarcoma causing acute renal failure: case report and review of the literature.

Granulocytic sarcoma, also known as chloroma or myeloid sarcoma, is a pathologic term generally used to describe extramedullary solid tumors composed of myeloblasts. Rarely, it can occur as an isolated finding of acute myeloid leukemia (AML), without bone marrow or blood involvement. Primary involvement of the urinary tract without evidence of leukemia is exceedingly rare. Here, we report a case of granulocytic sarcoma presenting as acute renal failure due to an obstructive bladder mass with mesenteric involvement. Although the bone marrow was not involved morphologically, inversion of chromosome 16 (inv[16][p13q22]) was identified by reverse transcription polymerase chain reaction (RT-PCR) testing. This case illustrates the importance of the prompt use of appropriate immunostaining and molecular testing to unveil the correct diagnosis due to the urgency in treatment initiation. We performed a literature review of this rare clinical presentation to alert physicians about the optimal diagnosis for prompt treatment.