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2015, Volume 31, Number 2, Page(s) 131-135     
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DOI: 10.5146/tjpath.2014.01258
Cutaneous Myeloid Sarcoma of the Penile Foreskin
Ruquiya AFROSE1, Deepa NEBHNANI2, Neelam WADHWA1
1Department of Pathology, University College of Medical Sciences, DELHI, INDIA
2Department of Uro-Pathology, Seth G S Medical College and KEM Hospital, MUMBAI, INDIA
Keywords: Myeloid leukemia, Chronic phase, Circumcision, Phimosis, Priapism

Myeloid sarcoma, considered to herald the onset of a blast crisis in the setting of chronic myeloproliferative neoplasm/dysplasia, typically presents during the course of the disorder. Cutaneous involvement is uncommon and lesions on genital skin are seldom seen. We present a case of a well-differentiated myeloid sarcoma in the penile foreskin in an apparently healthy 29-year-old male presenting with phimosis. The unusual composition of the inflammatory cell infiltrate, and characteristic sparing of dermal blood vessels, nerves and smooth muscle fibres led to the correct diagnosis. Absence of commonly observed changes in the circumcision skin like those of balanitis xerotica was also helpful. Detailed hematological work up revealed a previously undiagnosed chronic myeloid leukemia in chronic phase. The patient also had simultaneous priapism, another rare presentation of chronic myeloid leukemia. One year hence, the patient is in hematological remission with no evidence of extramedullary disease. Although priapism has been described as a rare presenting symptom in chronic myeloid leukemia, the present case is unique as this is the first time a cutaneous myeloid sarcoma has been documented in the penile foreskin.

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