Extramedullary Relapse of Acute Promyelocytic Leukemia in the Middle Ear after All-Trans Retinoic Acid Combined with Chemotherapy.

Authors

Noriko Tsuge, Taisuke Kobayashi, Masahiro Komori, Ichiro Murakami, Tatsuya Negishi, Shohei Shigeto, Yuta Tsunaga, Keito Ohara, Shinichiro Watanabe, Shohei Yoshida, Kensuke Kojima

Published in

Internal medicine (Tokyo, Japan). Sep 29, 2026. Epub Sep 29, 2026.

Abstract

A 69-year-old man with acute promyelocytic leukemia in molecular remission and no detectable PML::RARA transcripts in his peripheral blood cells developed acute otitis media. After 10 months, tympanomastoidectomy was performed for suspected secondary cholesteatoma. A histological examination confirmed extramedullary relapse with PML::RARA-positive cell infiltration. The patient achieved a second molecular remission after treatment with arsenic trioxide. Our findings suggest that (1) a diagnostic sample may be obtained from mastoid air cells rather than from the middle ear cavity, (2) molecular remission does not preclude extramedullary relapse, and (3) all-trans retinoic acid and arsenic trioxide combination therapy may reduce the risk of extramedullary relapse.

PMID:
42816398
Bibliographic data and abstract were imported from PubMed on 01 Oct 2026.

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