Sacral myeloid sarcoma involving multiple metastases to the brain: A case report

Abstract

The presentation of myeloid sarcoma (MS) in the bone is common; however, rarely does the tumor occur in the sacral spine, and in a normal patient with no history of acute myeloid leukemia. The present study describes the rare case of a previously healthy 24-year-old male patient, who presented with a history of six months of repeated pain in the right leg and hip and limping for less than a month, who was diagnosed with sacral MS. Despite receiving surgical management and chemotherapy promptly subsequent to the diagnosis and undergoing close observation following the treatment, the patient still developed metastases to multiple sites of the brain. Taking into account the similar presentation of this rare disease to other entities, the early and accurate diagnosis of MS is vital, and the condition should be considered as a threatening manifestation with the possibility of metastasis to other sites of the body.

Sacral Myeloid Sarcoma Manifesting as Radiculopathy in a Pediatric Patient: An Unusual Form of Myeloid Leukemia Relapse

“…The most suitable marker to identify MS is staining for myeloperoxidase. MS masses express lysozyme, Ki67, and myeloid/monocytoid antigens (CD13, CD14, CD33, CD64, CD68, and c-Kit (CD117)) [ 4 ].…”

“…MRI is the best imaging study to distinguish MS from other pathologies [ 4 ]. During MRI, MS commonly appears as a heterogeneous signal mass with isosignal or hypersignal intensity in T2-weighted images and with hyposignal or isosignal intensity in T1-weighted images, when compared to brain or muscle tissue [ 17 ].…”

“…MS is an uncommon neoplastic condition [ 4 , 5 ] and any organ system can be affected [ 1 ]. The soft tissue of the head, neck, skin, bone, and lymph nodes is usually affected [ 1 ].…”

“…Spinal MS of the sacrum is infrequent. Compressed spinal cord symptoms caused by an MS mass are unusual [ 1 , 4 ]. Early diagnosis of MS is possible using enhanced Magnetic Resonance Imaging (MRI).…”

“…This imaging technique can show the precise location and size of the lesion. Biopsy of the mass is required for a definitive MS diagnosis [ 4 ]. MS is a significant cause of morbidity among patients with leukemia.…”