Spontaneous Resolution of Aleukemic Leukemia Cutis: A Case Report

Case Report

Ann Hematol Oncol. 2016; 3(2): 1076.

Spontaneous Resolution of Aleukemic Leukemia Cutis: A Case Report

Joseph S* and Liu Y

Department of Internal Medicine, Pinnacle Health Network, USA

*Corresponding author: Sarah Joseph, Department of Internal Medicine, Pinnacle Health Network, 111 S Front St, Third floor Brady Building: Harrisburg, PA, USA

Received: February 25, 2016; Accepted: February 25, 2016; Published: April 13, 2016


A patient presented to her primary care physician with a skin rash; biopsy revealed leukemic cutis. Her peripheral blood demonstrated a slight increase in monocytes; however her bone marrow biopsy was negative for myeloblasts. The patient did not have any B symptoms and there was a complete resolution of her skin rash 3 months after diagnosis. The patient, 28 months after initial time of diagnosis, remained completely asymptomatic. This is the first reported case describing complete spontaneous resolution of leukemia cutis in an adult without a progression to systemic leukemia after more than 2 years of follow up.

Keywords: leukemia cutis; Spontaneous resolution


Leukemia cutis is a nonspecific term to describe skin manifestations of leukemia [1]. It is defined as a cutaneous infiltration by malignant leukocytes and is often associated with progression to acute myeloid leukemia (AML), chronic myeloproliferative disease and chronic myelogenous leukemia [2]. An estimated 10-15% of patients with systemic AML develop LC [3]. Aleukemic leukemia cutis (ALC) is the manifestation of leukemic cells in the skin without infiltration in the peripheral blood and bone marrow and is often associated with poor outcome [4].

Case Presentation

An 85 year old Caucasian female was referred to our hematology oncology clinic because of a biopsy proven diagnosis of leukemia cutis. The patient has a past medical history significant for ER/PR positive breast cancerT1N0Mx, diagnosed 8 years prior. She underwent a left partial mastectomy, subsequently completed adjuvant radiation therapy, and took anastrozole for 5 years. In the summer of 2013, the patient noticed a rash on her right flank, described as a 6-10mm oval infiltrated pink plaque (Figure 1). She had no complaints except the skin rash. She denied any B-like symptoms. Her primary care doctor referred her to a dermatologist for a punch biopsy. Pathology reports revealed leukemia cutis with monocytic differentiation. Immunohistochemistry revealed cells diffusely positive for lysozyme and, to a lesser degree, CD68. Cells stained negative for CD3, CD45RO and myeloperoxidase. The biopsy results were confirmed by two institutions. Peripheral blood revealed an increase in monocytes. Bone marrow biopsy reported hyper cellular maturing trilineage hematopoiesis; there was no evidence of blast cells. The patient returned to the clinic 3 months later. She expressed no complaints and her peripheral blood at that time was unremarkable except for slight monocytosis. By November 2013, 6 months post diagnosis by skin biopsy, the rash had completely resolved (Figure 2). There was nothing left to re-biopsy, and the patient remained asymptomatic. Two years after the diagnosis of aleukemic leukemia cutis, there was no progression to systemic leukemia. The rash did not return and there was no evidence of active malignancy. Repeat bone marrow biopsy was deemed clinically unnecessary.

Citation: Joseph S and Liu Y. Spontaneous Resolution of Aleukemic Leukemia Cutis: A Case Report. Ann Hematol Oncol. 2016; 3(2): 1076. ISSN : 2375-7965