Spinal Myeloid Sarcoma in Two Non-Leukemic Patients

Abstract

Myeloid sarcoma, formerly termed granulocytic sarcoma or chloroma, consists of neoplastic granulocytic precursors and myeloblasts. Isolated chloromas (granulocytic sarcomas) are rare tumors. Spinal complications of chloromas, such as cord compression secondary to epidural tumor or cauda equine syndrome have been described but are rare. We herein report two cases with spinal granulocytic sarcomas in non-leukemic patients. The case of a previously healthy 22-year-old man diagnosed with multiple spinal granulocytic sarcomas with no evidence of bone marrow or other hematological involvement is described. And, a 43-year-old woman diagnosed cervical spinal granulocytic sarcoma with no evidence of bone marrow or other hematological involvement is described. The tumor was totally removed by microsurgery. The histopathological examination was consistent with granulocytic sarcoma. Granulocytic sarcoma should be considered in the differential diagnosis of an epidural mass in patients with or without acute leukemia, because early diagnosis followed by appropriate combined chemotherapy and radiation may obviate surgical intervention and eventually prevent leukemic transformation.

Sacral canal myeloid sarcoma as initial manifestation of granulocytic leukemia: MRI features and differential diagnosis (with a case report)

“…Myeloid sarcoma might precede abnormalities of bone marrow and peripheral blood, and can be detected by CT or MRI as a solitary mass. It may also be initially noted as a solitary mass on imaging in patients whose peripheral blood and bone marrow are abnormal (5). Either way, misinterpretation of its image is frequent, as in the case we reported above.…”

Rare Intramedullary Myeloid Sarcoma Mistaken as Acute Transverse Myelitis

“…This unspecific presentation could easily be misdiagnosed with atypical inflammatory condition such as acute transverse myelitis and demyelinating diseases, which could lead to prolonged and inappropriate treatment and delay the timely diagnosis 5,7,12,16) . The diagnosis of spinal myeloid sarcoma is often challenging because the clinical and laboratory findings are usually not contributory 5,10) . The radiologic findings are usually non-specific, and the mass often appears as a soft tissue mass 2)…”

Epidural spinal cord compression as initial clinical presentation of an acute myeloid leukaemia: case report and literature review

“…Granulocytic sarcoma is frequently diagnosed simultaneously with or after the start of an acute myeloid leukaemia or may be the initial sign of a relapse in a patient in remission [3-9, 11, 15]. In non-leukemic patients, myeloid granulocytic sarcoma usually precedes acute myeloid leukaemia [16]. In 87 to 88 % of patients without hematologic abnormalities at diagnosis, acute myeloid leukaemia develops in the 10.5 to 11 following months [17].…”