Spinal Chloroma Presenting With Triplegia in an Aleukaemic Patient

Buckland, Michael E.; Scolyer, Richard A.; Donellan, Michael B.; Brew, Stefan; McGee-Collett, Martin; Harper, Clive

doi:10.1080/00313020120063045

Cited by 5 publications

(11 citation statements)

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“…Diagnosis of GS poses a diagnostic dilemma particularly in the absence of clinical features of underlying disorder. [ 1 2 3 ] GSs are often the initial presenting feature even when both are present at diagnosis. [ 1 3 4 ] However they may occur alone without peripheral blood or bone marrow evidence of leukemia,[ 5 ] with subsequent development of leukemia or as a site of leukemia relapse.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 2 3 ] GSs are often the initial presenting feature even when both are present at diagnosis. [ 1 3 4 ] However they may occur alone without peripheral blood or bone marrow evidence of leukemia,[ 5 ] with subsequent development of leukemia or as a site of leukemia relapse. [ 6 ] The incidence of GSs is rising due to early diagnosis, better chemotherapeutic and radio therapeutic facilities resulting in a longer survival of leukemia patients.…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 ] The incidence of GSs is rising due to early diagnosis, better chemotherapeutic and radio therapeutic facilities resulting in a longer survival of leukemia patients. [ 1 3 ] Only 15 patients with primary epidural GS of the spine in the literature have been reported. [ 1 2 3 4 5 7 8 9 10 ]…”

Section: Discussionmentioning

confidence: 99%

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Granulocytic sarcoma presenting as presenting as monoparesis: A rare case report

et al. 2014

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Granulocytic sarcomas (GSs) or myeloid sarcoma or chloroma are rare, destructive, extramedullary tumor masses that consist of immature granulocytic cells. We present case of a 35-year-old man presenting as monoparesis, diagnosed to have cervical intradural extramedullary mass lesion with an extradural extension. Although the history or physical examination had no symptoms and signs suggestive of leukemia, bone marrow study and blood picture indicated chronic myeloid leukemia. Surgical decompression was done, and histopathological examination was consistent with GS. GSs have been observed in patients with acute myelogenous leukemia, chronic myelogenous leukemia, and other myeloproliferative disorders, but rarely have been reported as first presentation of the disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Granulocytic sarcoma presenting as presenting as monoparesis: A rare case report

et al. 2014

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“…[67] Newly diagnosed patients with isolated granulocytic sarcomas usually treated with aggressive chemotherapy as if they have acute myelogenous leukemia; cures are not attained with radiation therapy alone. [6] Surgery is generally preferred for cases of acute spinal cord compression in cases with out systemic evidence of leukemia.…”

Section: Discussionmentioning

confidence: 99%

“…[6] Surgery is generally preferred for cases of acute spinal cord compression in cases with out systemic evidence of leukemia. [78] Early diagnosis followed by appropriate combined chemotherapy and radiation may obviate surgical intervention and eventually prevent leukemic transformation. Chloroma, though rare, should be considered in the differential diagnosis of any epidural mass lesion and peripheral smear examination and bone marrow study, if necessary, should be done in all cases.…”

Section: Discussionmentioning

confidence: 99%

Unusual case of paraplegia

Amalraj

Syamlal

2009

Ann Indian Acad Neurol

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Paraplegia due to a spinal cord epidural mass is an extremely rare presentation of undiagnosed leukemia. We are reporting a case of 14-year-old girl, who presented with paraplegia due to thoracic epidural mass, as the initial presenting manifestation of acute myeloid leukemia. Granulocytic sarcoma or chloroma should be considered in the differential diagnosis of an epidural mass in patients with or with out leukemia granulocytic sarcoma, which are rare extramedullary tumor-like proliferation of myelogenous precursor cells that may de novo precede acute leukemia or coincide with the first manifestation or relapse of acute myeloid leukemia.

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Paraplegia as the presenting manifestation of extramedullary megakaryoblastic transformation of previously undiagnosed chronic myelogenous leukemia

2006

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Extramedullary tumors, also known as granulocytic sarcomas (GS), occur most frequently in acute myelogenous leukemia (AML). They may signal the onset of the accelerated phase of chronic myelogenous leukemia (CML) or the blastic transformation of a myeloproliferative disorder. Occasionally, a GS may be the presenting sign of undiagnosed AML, and rarely the presenting sign of undiagnosed CML or aleukemic leukemia. Paraplegia due to a spinal cord GS is an extremely rare presentation of undiagnosed leukemia. This is the first case report of paraplegia as the presenting manifestation of extramedullary megakaryoblastic transformation of previously undiagnosed CML. A 53-year-old woman reported back pain for 6 days, rapidly progressing to paraplegia. Physical examination noted a large abdominal mass and flaccid paralysis in both lower extremities. Spinal MRI revealed a T4-T6 vertebral mass causing spinal stenosis and cord compression. Tumor debulking and laminectomy were performed emergently. The tumor consisted of noncohesive blast cells. The CBC revealed a leukocyte count of 238,300/ml and a differential consistent with CML. Reexamination of the patient found that the abdominal mass was a giant spleen. Further immunohistochemical studies of the tumor were consistent with extramedullary acute megakaryoblastic blast transformation of CML. Although extramedullary blast crises herald the accelerated phases in~10% of CML cases, megakaryoblastic blast transformation of CML accounts for less than 3% of these cases. The combination of acute paraplegia and megakaryoblastic transformation in a previously undiagnosed patient with CML is extremely rare and may pose a diagnostic dilemma. Am. J. Hematol. 82:150-154, 2007. V V C 2006 Wiley-Liss, Inc.

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Spinal Chloroma Presenting With Triplegia in an Aleukaemic Patient

Cited by 5 publications

References 0 publications

Granulocytic sarcoma presenting as presenting as monoparesis: A rare case report

Granulocytic sarcoma presenting as presenting as monoparesis: A rare case report

Unusual case of paraplegia

Paraplegia as the presenting manifestation of extramedullary megakaryoblastic transformation of previously undiagnosed chronic myelogenous leukemia

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