Granulocytic Sarcoma of the Spine in Nonleukemic Patients: Report of Three Cases

Abstract

Granulocytic sarcomas in nonleukemic patients are rare, and when they affect the spine they are frequently misdiagnosed. Appropriate therapy for these tumors requires early identification.

Spinal Epidural Granulocytic Sarcoma in a Child Precedent to Clinical Manifestation of Acute Myeloid Lymphoma -Case Report-

“…Five patients finally diagnosed as AML, and 4 of these 5 patients died within a relatively short time (mean 11 months). 8,13,24,25) On the other hand, among the 5 patients who did not develop AML, only one patient died. 23) Retrospectively, our patient showed the typical manifestation of pediatric spinal epidural granulocytic sarcoma preceding clinical manifestation of leukemia.…”

“…7,8,12,13,16,21,[23][24][25] Nine of the 10 patients were males, and the mean age was 11 years. The male predominance might be associated with the higher incidence of AML in males.…”

“…18) At the same time, the chemotherapy intended for AML prolongs the nonleukemic and the survival periods in patients with granulocytic sarcoma but without leukemia. 8,9,26) Therefore, prompt diagnosis and adequate treatment, including surgery, are essential to achieving good outcomes, although pediatric granulocytic sarcoma is rare as an initial symptom of spinal compression.…”

“…18,22) The histological diagnosis of granulocytic sarcoma can be difficult before the manifestation of AML, 4,8,17) and 47% of granulocytic sarcomas are initially misdiagnosed, mostly as malignant lymphoma, 26) but also as neuroblastoma, rhabdomyosarcoma, Ewing sarcoma, or peripheral neuroectodermal tumor. 3) Granulocytic sarcomas generally occur in the soft tissues, bone, and skin, 15,18) whereas the spinal column is much less commonly involved, with an incidence of 13% to 19%.…”

MYC and PIM2 Co-Expression in Mouse Bone Marrow Cells Readily Establishes Permanent Myeloid Cell Lines That Can Induce Lethal Myeloid Sarcoma In Vivo

“…Furthermore we have demonstrated that on transplantation to syngeneic mice, the cell line will only form lethal sarcomas in vivo, with nearly undetectable numbers of circulating leukemic cells evident. In humans, myeloid sarcomas, also called chloromas, are a very rare presentation in leukemic malignancies or pre-leukemic states, and are most commonly associated with myeloproliferative or myelodysplastic syndromes in progression to genuine leukemia (Deme et al, 1997). Since our model exclusively forms myeloid sarcomas, it is likely to prove useful in studying molecular processes of transformation leading to myeloid sarcoma development.…”