Extramedullary hematopoiesis causing spinal cord compression in polycythemia vera: A case report and literature review

Cailleteau, Axel; Agbetsivi, Komivi; Guimas, V.; Supiot, S.; Ollivier, Laurence

doi:10.1016/j.ctro.2022.09.009

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Consequently, due to its rare occurrence, there is no definitive approach to the management of this condition. Current treatment options have remained varied in the literature, consisting of the use of RT alone, 28 , 32 ,33 surgical decompression, 18 ,33,34 and surgical decompression with the sequential use of post–radiation therapy and various chemotherapies and transfusion therapies. 35–38…”

Section: Discussionmentioning

confidence: 99%

Spinal extramedullary hematopoiesis mimicking an epidural tumor in a patient with high-risk polycythemia vera: illustrative case

Hawkins,

Breton,

Bhatnagar

et al. 2024

J Cosmet Laser Ther

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BACKGROUND Here the authors present the case of a 43-year-old male with a history of T-cell lymphoma, which was treated with azacitidine plus cyclophosphamide, doxorubicin, vincristine, and prednisone and autologous hematopoietic cell transplant, and high-risk polycythemia vera (PCV) presenting with severe lower-back pain radiating to the bilateral legs with associated lower-extremity weakness and splenomegaly. OBSERVATIONS T2-weighted magnetic resonance imaging revealed multilevel epidural lesions involving T1–10 and S1–2. Because of severe spinal canal stenosis, the patient underwent surgical decompression of T5–7, with immediate postoperative alleviation of the lower-extremity pain and complete resolution of the lower-leg weakness. Biopsy results revealed extramedullary hematopoiesis (EMH) mimicking a spinal epidural tumor. EMH is radiosensitive and displays a rapid response to low dosages, so the patient was further treated with palliative radiation therapy for residual tumors and symptom alleviation, as well as hydroxyurea and corticosteroids as indicated for cytoreduction. LESSONS EMH associated with PCV or myeloproliferative conditions occurring within the spine is a rare phenomenon without a standard treatment approach. https://thejns.org/doi/10.3171/CASE23659

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Section: Discussionmentioning

confidence: 99%

Spinal extramedullary hematopoiesis mimicking an epidural tumor in a patient with high-risk polycythemia vera: illustrative case

Hawkins,

Breton,

Bhatnagar

et al. 2024

J Cosmet Laser Ther

View full text Add to dashboard Cite

show abstract

“…[4] Spinal EMH-associated spinal cord compression can damage the ascending and descending spinal cord pathways and destroy neuronal microcirculation, and early surgical treatment is recommended for patients with activity limitations of the lower limbs. [10] However, traditional open laminectomy induced large trauma and more hemorrhage and aggravates the symptoms of anemia postoperatively, which is not conducive to the patient rehabilitation. Recently, UBE is being widely used in China since it induces less trauma, bleeding, and pain.…”

Section: Discussionmentioning

confidence: 99%

Unilateral bi-portal endoscopy for the treatment of thalassemia with extramedullary hematopoietic compression of the spinal cord: Two case reports

Lin,

Lai,

Zhu

et al. 2023

Medicine

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Rationale: Thalassemia combined with extramedullary hematopoietic spinal cord compression is extremely rare; its ideal treatment is still controversial. Herein, we present 2 cases of thalassemia combined with extramedullary hematopoietic compression of the spinal cord wherein satisfactory results were obtained using unilateral bi-portal endoscopy (UBE). Patient concerns: Case 1 was of a 43-year-old male who presented with a chief complaint of numbness of the left lower limb since 1-month. Case 2 involved a 23-year-old male who was admitted to the hospital with a chief complaint of numbness in both toes since 3 months and walking instability since 2 weeks. Both cases had a history of being diagnosed with thalassemia. Diagnoses: Computed tomography and magnetic resonance imaging showed spinal canal space-occupying lesions causing dural compression and spinal stenosis. Postoperative pathology confirmed the spinal canal lesions to be extramedullary hematopoietic tissue. Interventions: For spinal canal decompression, UBE supplemented by blood transfusion was performed for both cases. Outcomes: All preoperative symptoms were relieved postoperatively; no recurrence was noted at the 6-month follow-up. Lessons: Thalassemia combined with extramedullary hematopoiesis can lead to acute spinal cord compression. UBE significantly relieves spinal stenosis symptoms; furthermore, UBE combined with blood transfusion for spinal canal extramedullary hematopoiesis gives satisfactory results, is safe, and has a low risk of spinal cord injury.

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Hydroxycarbamide/Ruxolitinib

2024

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Extramedullary hematopoiesis causing spinal cord compression in polycythemia vera: A case report and literature review

Cited by 3 publications

References 23 publications

Spinal extramedullary hematopoiesis mimicking an epidural tumor in a patient with high-risk polycythemia vera: illustrative case

Spinal extramedullary hematopoiesis mimicking an epidural tumor in a patient with high-risk polycythemia vera: illustrative case

Unilateral bi-portal endoscopy for the treatment of thalassemia with extramedullary hematopoietic compression of the spinal cord: Two case reports

Hydroxycarbamide/Ruxolitinib

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