A Rare Etiology of Small Intestinal Obstruction - Solitary Myelogenic Sarcoma of the Small Intestine: CT Findings and a Review of the Literature

Background: Myelocytic sarcoma is a rare extramedullary tumor consisting of immature myeloid cells-granulocytes, mononuclear cells, or both. It usually occurs in patients with acute or chronic myeloid leukemia and is often found in the skin, bone, and lymphatic tissues. Isolated myeloid sarcomas are more uncommon in patients without leukemia in the small intestine. Case presentation: In the present study, a hospitalized case is discussed with intestinal obstruction as the primary symptom. During the CT examination, the local intestinal wall of the jejunum was found to possess ring thickening, intestinal lumen stenosis and proximal intestinal obstruction. The tumor presented with uniform and moderate progressive enhancement. The patient underwent emergency laparoscopic surgery in order to remove the tumor. Immunohistochemical staining on postoperative paraffin sections revealed myelosarcoma. The patient also underwent a bone marrow biopsy to exclude acute and chronic myeloid leukemia and the bone marrow smear indicated normal range. Conclusions: Myeloid sarcoma must be included in the differential diagnosis of small intestinal tumors, although the patient may not have history of leukemia. Radiologists should improve their imaging perception of myelosarcoma.