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Salgüero-Fernández" "autores" => array:3 [ 0 => array:4 [ "nombre" => "F.J." "apellidos" => "Rodríguez-Cuadrado" "email" => array:1 [ 0 => "franciscojose.rodriguezcuadrado@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "Silvestre-Egea" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "I." "apellidos" => "Salgüero-Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sarcoma mieloide tras remisión «completa» de leucemia mieloide aguda" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 480 "Ancho" => 650 "Tamanyo" => 73944 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An 87-year-old woman presented with a 1-year old lesion on her left leg. The patient had a history of acute myeloid leukemia with trilineage dysplasia and BCR-ABL p1.90 mutation, for which she received chemotherapy until complete remission 18 years earlier. Physical examination revealed the presence of a 17<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>13<span class="elsevierStyleHsp" style=""></span>cm hyperkeratotic plaque of a yellowish-brown color with papillomatous projections of a villous appearance, on a highly infiltrated 21<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>16.5<span class="elsevierStyleHsp" style=""></span>cm erythematous-squamous base (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Biopsy of the lesion confirmed the dermal infiltration of polygonal eosinophilic cells with an elevated number of mitoses, pleomorphic nuclei, and karyorrhexis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2A and 2B</a>). Immunohistochemistry tested positive for CD123 (a marker for malignant hematologic neoplasms, including plasmacytoid dendritic cell neoplasm or acute myeloid leukemia) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2C</a>), and for CD43, CD45, CD99, CD117, and Bcl-2. Molecular study showed a mutated/non-mutated FLT3 ratio of 0.78; a pathogenic mutation in exon 12 of NPM1; and expression of the WT1 gene, without identification of the BCR-ABL mutation. These findings led to a diagnosis of myeloid sarcoma associated with the previous myeloproliferative process.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was treated with radiotherapy (1<span class="elsevierStyleSup">st</span> cycle of 4<span class="elsevierStyleHsp" style=""></span>Gy fractionated in 2 sessions and 2<span class="elsevierStyleSup">nd</span> cycle of 20<span class="elsevierStyleHsp" style=""></span>Gy fractionated in 10 sessions) and chemotherapy (8 cycles of azacitidine 100<span class="elsevierStyleHsp" style=""></span>mg every 24<span class="elsevierStyleHsp" style=""></span>h for 7 days per cycle and midostaurin 50<span class="elsevierStyleHsp" style=""></span>mg every 12<span class="elsevierStyleHsp" style=""></span>h). Two years after diagnosis, the patient was still very responsive to therapy.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 480 "Ancho" => 650 "Tamanyo" => 73944 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 371 "Ancho" => 1000 "Tamanyo" => 181605 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011500000009/v2_202410160548/S0001731024006458/v2_202410160548/en/main.assets" "Apartado" => array:4 [ "identificador" => "41021" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes en Dermatología" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011500000009/v2_202410160548/S0001731024006458/v2_202410160548/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731024006458?idApp=UINPBA000044" ]
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