Unexpected sudden death due to acute myeloid leukemia subtype M5: a case report and review of the literature

Acute myeloid leukemia (AML) is one of the most frequent myeloid malignancies. In patients with the disease, death often occurs due to complications of marrow failure, such as sepsis or significant hemorrhage. Rarely, undiagnosed and rapid evolving cases may present with fatal multi-organ failure. The authors report a case of sudden death in a 67-year-old woman who had been in apparent good health. A thorough post-mortem investigation performed on the decedent led to the diagnosis of acute myeloid leukemia subtype M5. Autopsy and histopathologic findings allowed us to determine AML complicated by multiple organ failure as the cause of the death. The case report suggests that underlying acute myeloid leukemia should be included in the differential diagnosis of sudden death with multisystem organ failure, however rare. Actually, it represents a quite unusual cause of sudden death, rarely reported in the medicolegal literature. A complete forensic approach by means of autopsy, histological and immunohistochemical analyses is deemed essential in order to correctly determine both the cause and the mode of death.