OBJECTIVE: Myeloid sarcomas (MSs) are rare tumors of myeloid blasts and immature cells. Rare cases of splenic involvement are on record. We report a case of MS in a young female which is confirmed on pathologic examination of the spleen.

PATIENTS AND METHODS: A 20-year-old female was admitted with the chief complaints of abdominal pain, fever, anorexia, and dyspnea. She was a known case of acute myelogenous leukemia (AML). The spiral computed tomography scan without contrast showed a massive splenic enlargement. The ultrasound examination showed liver and spleen were larger than normally measured 190 and 210 mm, respectively, with normal parenchymal echo.

RESULTS: The patient underwent surgery with clinical suspicion of MS. The specimen consisted of the red spleen with several infarcted areas totally measuring 22x14x10 cm and weighing 1885 g. The pathology report was splenic infarction with myeloid sarcoma.

CONCLUSIONS: The risk of misdiagnosis is high in the pathologic exam, especially in non-leukemic forms and low clinical suspicion. It is important to consider this entity in the differential diagnosis of splenomegaly or splenic mass in any age group.