Temporal Bone Myeloid Sarcoma

A 69-year-old male previously diagnosed with acute myeloblastic leukemia secondary to myelodysplastic syndrome (LMA with dysplasia, karyotype 46XY, and no cytogenetics abnormalities) refractory to treatment (hydroxyurea, cytarabine, mitoxantrone, and azacitidine) presented with right-side otalgia, otorrhea, and deafness with 2 months progression. He had been treated with oral ciprofloxacin, eardrops with dexamethasone + neomycin + polymyxin B and ibuprofen without success. Otoscopy showed polypoid tissue in the concha of the auricle, otorrhea, and tympanic membrane purple bulging (Fig. 1). Patient was hospitalized with the suspicion of malignant external otitis, and intravenous ciprofloxacin, ceftazidime, and meropenem were prescribed. Investigations revealed hemoglobin 8.6 g/dL, leucocytes 43.2 × 10 g/L, platelets of 24 × 10 g/L, and negative blood cultures. Head computerized tomography (CT) demonstrated tissue fullness of right antrum, mastoid, and