Case ReportAggressive Myeloid Sarcoma Causing Recurrent Spinal Cord Compression
Introduction
Myeloid sarcoma, previously known as granulocytic sarcoma or chloroma (9), is a rare extramedullary solid tumor comprised of immature myeloid precursor cells. Tumor locations are widely variable, but have been known to involve the spinal canal. They are most commonly associated with a previous diagnosis of acute myelogenous leukemia (AML), and have an incidence of 2.9%–3.1% in these patients 11, 14. They can also precede the diagnosis of AML (16). Myeloid sarcoma has also been associated with other myelodysplastic and myeloproliferative disorders, but may occur in isolation (2). Presence of myeloid sarcoma is generally regarded as a poor prognostic indicator from a hematologic standpoint (18), although nonleukemic myeloid sarcoma may have increased survival in comparison with AML (20). We present a case of recurrent, aggressive myeloid sarcoma presenting as acute spinal cord compression in a patient with a history of Shwachman-Diamond syndrome and AML.
Section snippets
History and Physical Examination
A 20-year-old man with a history of Shwachman-Diamond syndrome and refractory AML presented with acute onset weakness and numbness in his lower extremities. Previous treatment history included chemotherapy and bone marrow transplant. Approximately 1 week before presentation, he developed midthoracic pain that migrated to his left scapular region and was initially resolved with nonsteroidal anti-inflammatory agents. On the day before presentation, the patient noticed onset of right lower
Discussion
Myeloid sarcoma is relatively uncommon, occurring in 3% of patients with AML 11, 14. Those involving the spinal column or spinal cord are rare, and the optimal treatment for cases presenting with neurological complications has not been established. A recent case series of the literature identified 55 cases with myeloid sarcoma and spinal complications, with most receiving a combination of surgery, chemotherapy, or radiotherapy (12). However, the timing of these therapies in the acute setting of
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Cited by (10)
In Reply to “Unusual Cause of Cord Compression–A Pressing Issue for Neurosurgeons”
2016, World NeurosurgeryUnusual Cause of Cord Compression—A Pressing Issue for Neurosurgeons
2016, World NeurosurgeryMyeloid sarcoma of the thoracic spine: A case report
2023, Surgical Neurology InternationalPriapism from myeloid sarcoma of the sacral canal in a 6-year-old patient
2022, Pediatric Hematology and OncologyDiagnosis and surgical treatment of primary isolated aggressive lumbar myeloid sarcoma: a rare case report and review of the literatures
2021, BMC Musculoskeletal DisordersEpidural myeloid sarcoma as the presenting symptom of chronic myeloid leukemia blast crisis
2020, Clinical Rheumatology
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.