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CC BY-NC-ND 4.0 · World J Nucl Med 2022; 21(03): 255-260
DOI: 10.1055/s-0042-1751039
Interesting Case

An Unusual FDG-PET/CT Documentation in Aleukemic Leukemia Cutis: Atypical Penile, Scrotal, and Leg Muscles Involvement

Sunita Nitin Sonavane
1   Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Parel, Maharashtra, India
,
Sandip Basu
1   Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Parel, Maharashtra, India
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Abstract

Aleukemic leukemia cutis (ALC) is a rare condition with a relatively poor prognosis, clinically presenting as skin and subcutaneous nodules commonly involving head and neck region with discrete atypical leukemic cells infiltrating in the skin on histopathology. The lesions on the genital area skin are seldom reported. A 49-year-old male presented with joint pains and multiple subcutaneous nodules clinically with biopsy proving it as leukemia cutis. Bone marrow aspiration and biopsy were suggestive of normocellular myeloid preponderant bone marrow with mild increase in eosinophils. The 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) revealed metabolically active FDG avid ill-defined soft tissue attenuation involving the entire length of penile shaft with central necrotic area, diffuse scrota skin thickening, and lateral compartment muscles of left leg, in addition to multiple hypermetabolic metastatic lymph nodes, and diffuse hypermetabolic marrow in humerii and femora. Despite prompt investigations and initiation of management, the patient succumbed in 15 days post-FDG PET/CT. The present report depicts an atypical case of ALC, with FDG PET-CT showing extensive and unusual sites of disease involvement, emphasizing its potential role in ALC.

Keywords

aleukemic leukemia cutis - 18F-FDG PET/CT - penile and scrotal involvement - cutaneous manifestation - cancer imaging


Publication History

Article published online:
16 August 2022

© 2022. World Association of Radiopharmaceutical and Molecular Therapy (WARMTH). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Aleukemic leukemia cutis: clinical and immunohistochemical profiling. J Am Acad Dermatol 2014; 70 (05) AB121
    CrossrefGoogle Scholar
  • 2 Wang CX, Pusic I, Anadkat MJ. Association of leukemia cutis with survival in acute myeloid leukemia. JAMA Dermatol 2019; 155 (07) 826-832
    CrossrefPubMedGoogle Scholar
  • 3 Martínez-Leboráns L, Victoria-Martínez AM, Torregrosa-Calatayud JL, Alegre de Miquel V. Leukemia cutis: a report of 17 cases and a review of the literature. Actas Dermosifiliogr 2016; 107 (09) e65-e69
    CrossrefPubMedGoogle Scholar
  • 4 Maughan C, Kolker S, Markus B, Young J. Leukemia cutis coexisting with dermatofibroma as the initial presentation of B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma. Am J Dermatopathol 2014; 36 (01) e14-e15
    CrossrefPubMedGoogle Scholar
  • 5 Blattner C, DeDonato A, Blochin E, Kazlouskaya V, Elston DM. Initial presentation of acute myelogenous leukemia in the infiltrate underlying an actinic keratosis. Indian Dermatol Online J 2014; 5 (04) 508-509
    CrossrefPubMedGoogle Scholar
  • 6 Zheng J, Xue Q, Lin K, Miao W. Widespread skin infiltration of leukemia cutis on 18F-FDG PET/CT. Clin Nucl Med 2020; 45 (11) e489-e490
    CrossrefPubMedGoogle Scholar
  • 7 Afrose R, Nebhnani D, Wadhwa N. Cutaneous myeloid sarcoma of the penile foreskin. Turk Patoloji Derg 2015; 31 (02) 131-135
    PubMedGoogle Scholar
  • 8 Ng A, Gurun M. Cutaneous manifestation of leukaemia on the penis-the possible implications. J Surg Case Rep 2020; 2020 (12) a549
    CrossrefPubMedGoogle Scholar
  • 9 Plaza JA, Comfere NI, Gibson LE. et al. Unusual cutaneous manifestations of B-cell chronic lymphocytic leukemia. J Am Acad Dermatol 2009; 60 (05) 772-780
    CrossrefPubMedGoogle Scholar
  • 10 Krooks JA, Weatherall AG. Leukemia cutis in acute myeloid leukemia signifies a poor prognosis. Cutis 2018; 102 (04) 266 , 271, 272
    PubMedGoogle Scholar
  • 11 Haidari W, Strowd LC. Clinical characterization of leukemia cutis presentation. Cutis 2019; 104 (06) 326-330 , E3
    PubMedGoogle Scholar