{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:09:09Z","timestamp":1778476149804,"version":"3.51.4"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Myeloid sarcoma (MS) is a rare extramedullary tumor of myeloid blasts that may occur before, concurrently with, or after acute myeloid leukemia (AML) (1\u20134). We report a 53-year-old man with progressive left lower-limb pain and swelling, initially admitted to the vascular surgery service, with imaging revealing left external iliac vein and proximal common femoral vein occlusive thrombosis, a peri-iliac mass encasing the iliac vessels, and ipsilateral hydronephrosis. Biopsy of the left inguinal lesion showed MPO positivity, CD34 positivity, partial TdT positivity, and a Ki-67 index of about 80%, supporting myeloid sarcoma. Bone marrow studies confirmed AML with maturation, with 55% blasts, a myeloid immunophenotype, CEBPA (TAD1) positivity, and a complex karyotype. Baseline fluorine-18 fluorodeoxyglucose positron emission tomography\/computed tomography (18F-FDG PET\/CT) demonstrated irregular perivascular soft tissue extending from the left common to external iliac vessels, with mild FDG uptake. The patient received AML-directed therapy, including two IA cycles and high-dose cytarabine, achieving morphologic complete remission with a marked PET\/CT response. During follow-up, measurable residual disease (MRD) fluctuated repeatedly despite continued morphologic remission, prompting venetoclax-based therapy, including cytarabine plus venetoclax, azacitidine plus venetoclax with homoharringtonine, and later azacitidine plus venetoclax combined with tislelizumab. At the last follow-up in December 2025, the patient remained alive. This case highlights that peri-iliac MS may mimic vascular and urologic disease and that serial MRD monitoring can be useful for guiding postremission treatment adaptation in AML with extramedullary disease.<\/jats:p>","DOI":"10.3389\/fonc.2026.1838693","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T04:26:25Z","timestamp":1778473585000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Iliac perivascular myeloid sarcoma presenting with iliofemoral deep vein thrombosis and hydronephrosis"],"prefix":"10.3389","volume":"16","author":[{"given":"Zhao","family":"Shan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital)","place":["Lanzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital)","place":["Lanzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Honggang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dongguan Taixin Hospital","place":["Dongguan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaxuan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, Wuwei People's Hospital","place":["Wuwei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyi","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital)","place":["Lanzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2017.02.027","article-title":"Myeloid sarcoma: Presentation, diagnosis, and treatment","volume":"17","author":"Almond","year":"2017","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1159\/000497210","article-title":"Myeloid sarcoma","volume":"42","author":"Magdy","year":"2019","journal-title":"Oncol Res Treat"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2023.04.009","article-title":"Myeloid sarcoma: An overview","volume":"40","author":"Ramia de Cap","year":"2023","journal-title":"Semin Diagn Pathol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-023-05288-1","article-title":"Myeloid sarcoma: More and less than a distinct 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meta-analysis","volume":"17","author":"Padmanabhan","year":"2025","journal-title":"Cancers (Basel)"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.0253-2727.2020.08.016","article-title":"Venetoclax combined with azacitidine in the treatment of myeloid sarcoma: Three case reports and literature review","volume":"41","author":"Tian","year":"2020","journal-title":"Zhonghua Xue Ye Xue Za Zhi"}],"container-title":["Frontiers in 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