HD Jung, et al Ann Dermatol Vol. 23, Suppl. 2, 2011 CASE REPORT http://dx.doi.org/10.5021/ad.2011.23.S2.S270 Multiple Granulocytic Sarcomas in a Patient with Longstanding Complete Remission of Acute Myelogenous Leukemia Hee-Dam Jung, M.D., Hei-Sung Kim, M.D., Young-Min Park, M.D., Hyung-Ok Kim, M.D., Jun-Young Lee, M.D. Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Granulocytic sarcoma is an extramedullary tumor composed of granulocytic precursor cells. It usually presents as a nodular mass in the course of acute myelogenous leukemia. Rarely, the tumor develops in non-hematological conditions or in a patient with complete remission from the acute myelogenous leukemia. In such cases, aleukemic granulo- cytic sarcoma can be a preceding sign of systemic leukemia or a first sign of hematologic relapse of leukemia. We present an unusual case of multiple granulocytic sarcomas develo- ped in a patient with longstanding complete remission of acute myelogenous leukemia, who has not had bone marrow and peripheral blood involvement for a long time. (Ann Dermatol 23(S2) S270∼S273, 2011) -Keywords- Aleukemic leukemia cutis, AML M1, Granulocytic sarco- ma INTRODUCTION Granulocytic sarcomas usually occur during the course of Received March 23, 2011, Revised July 12, 2011, Accepted for publication August 12, 2011 Corresponding author: Jun-Young Lee, M.D., Department of Der- matology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-040, Korea. Tel: 82-2-2258-1386, Fax: 82-2-594-3255, E-mail: jylee@catholic.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. S270 Ann Dermatol acute myelogenous leukemia (AML) and antecede blastic cirisis in myeloproliferative disease or myelodysplastic syndromes. However, the tumor can also develop in patients who have either no prior history of hematological disease or have shown complete remission from acute myelogenous leukemia. Herein, we describe a patient who has shown an unusual clinical course in that she was in complete remission from AML for a long time and that there were no signs of peripheral blood and bone marrow relapse for a long time following the development of granulocytic sarcoma. CASE REPORT A 72-year-old Korean woman presented with a 1-month history of rapidly growing multiple cutaneous nodules on the whole body. Physical examination revealed wide- spread well-demarcated variable-sized greenish firm cutaneous nodules over the face, trunk and extremities (Fig. 1). She had a history of acute myeloblastic leukemia without maturation (AML M1), and achieved complete remission after the 3rd consolidation chemotherapy, ten years ago. The patient remained asymptomatic for nine years and then visited the hospital presenting with an asymptomatic solitary firm mass on the left upper eyelid in September 2009. An excisional biopsy of the lesion was performed and histopathologic findings were consistent with a granulocytic sarcoma. Bone marrow biopsy showed normocellular bone marrow without leukemic cell involvement and peripheral blood also revealed normal findings. In April 2010, she complained of nasal stuffiness, bloody nasal discharge and hoarseness. Neck computed tomography and magnetic resonance imaging findings