PMC5862674_01
Relapse of chloroma in the left forearm after extirpation and post-radiotherapy image showing complete response.
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At this time, the patient refused chemotherapy and radiotherapy to 30-36 Gy was proposed (Fig. 1).
Relapse after radiotherapy initially with isolated skin nodule with rapid progression.
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At one-month follow-up the patient remained disease-free but in next evaluation the patient developed local relapse (Fig. 2) and physical examination showed left axillary and supraclavicular masses.
CT scan revealing left supraclavicular and axillary pathological lymph nodes.
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The CT scan revealed pathological cervical/supraclavicular left lymph nodes and a left axillary mass of 45 x 70 mm (Fig. 3).
Target delineation GTVt (dark blue), CTVt (pink), skar (light blue) and PTV (red). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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Bone marrow tests and immunophenotyping at this time showed progression to LMA, with evidence of 20% of myeloid blasts with a prominent monocytic component.Fig. 4.