Recurrent cardiac chloroma presenting as acute chest pain

Abstract

### Learning Point for Clinicians Granulocytic sarcoma should be a part of the differential diagnosis of patients who present with mass lesions after allogeneic transplant for chronic myeloid leukemia, even in the absence of hematologic relapse. A 41-year-old man presented to the hospital with sudden onset of chest tightness. His past medical history was notable for diagnosis of chronic myeloid leukemia (CML), made at 33 years. He was treated with imatinib, dasatinib and allogeneic peripheral blood stem cell transplant (PBSCT) with HLA mismatched, unrelated donor and he was still in complete hematologic response. On admission, his vital signs and cardiac enzymes were normal. Right ventricular hypertrophy was newly developed compared with his previous electrocardiography. He got an urgent coronary angiography due to ongoing chest pain, and the result showed no significant stenosis but anomalous tumor feeding vessels from left circumflex artery. A huge branch of left circumflex artery was supplying …