Granulocytic Sarcoma (Chloroma) Masquerading as Nodular Scleritis

Abstract

Abstract: : Purpose: To describe the first case of an unusual presentation of a granulocytic sarcoma in an adult involving the bulbar conjunctiva and sclera. Methods: A clinicopathologic case study is presented, including diagnostic workup, pathologic examination, and subsequent treatment. Results: A 42–year–old patient presented with a four–week history of progressive redness and irritation of the right eye. Her medical history was significant for acute myelogenous leukemia which had been in remission for 2 months. On examination, she was found to have a yellow, nodular lesion involving the temporal aspect of her bulbar conjunctiva and sclera. She was initially diagnosed with nodular scleritis and was treated with topical corticosteroids with no clinical improvement. Subsequently, the patient underwent an excisional biopsy that confirmed the diagnosis of granulocytic sarcoma (chloroma). Conclusions: Granulocytic sarcoma (chloroma) is a rare extramedullary soft tissue tumor typically associated with childhood leukemia. Based on this case study, leukemic patients of any age who present with a conjunctival or scleral lesion should undergo biopsy to rule out granulocytic sarcoma.

Keywords: oncology