Spinal granulocytic sarcoma (chloroma) presenting as acute cord compression in a nonleukemic patient

Abstract

The case of a previously healthy 24-year-old man diagnosed with extradural thoracic granulocytic sarcoma with no evidence of bone marrow or other hematological involvement is described. The tumor was removed totally by microsurgery. The histopathological examination was consistent with granulocytic sarcoma. Granulocytic sarcomas are most commonly found in the context of an acute myelogenous leukemia or in chronic myelogenous leukemia. They rarely have been reported in otherwise healthy patients without any evidence of systemic disease. A review of the literature revealed only 14 more nonleukaemic cases with granulocytic sarcoma causing thoracic spinal cord compression.

Spinal Granulocytic Sarcoma Manifesting as Radiculopathy in a Nonleukemic Patient -Case Report-

“…Eight patients developed acute leukemia, 6,14,16,18,20,25,26,30) and six patients died following leukemic relapse or graft versus host disease. 6,14,16,18,20,26) On the other hand, 13 of the 26 patients showed no bone involvement, 2,[5][6][7]9,11,12,17,27,28) and only four patients died of chemotherapy or radiotherapy related clinical disorders. 6,7,17,24) This finding possibly reflects the aggressive initial treatment and prevention of progression to leukemia.…”

“…2,[5][6][7][9][10][11][12]14,[16][17][18][19][20][21][22][23][24][25][26][27][28]30) The male predominance could be associated with the higher incidence of acute myeloid leukemia in men. 4) The affected sites included two cases at cervical, 17 at thoracic, 10 at lumbar, and three at sacral spinal levels.…”

“…13) Granulocytic sarcoma most commonly occurs in the soft tissues of the head and neck, bone, and skin, 9) and less often in the central nervous system and spinal cord. 2,[5][6][7][9][10][11][12][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]30) Granulocytic sarcoma seldom manifests before the identification of leukemia in the peripheral blood or bone marrow. 2,[5][6][7][9][10][11][12][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]30) The finding of granulocytic sarcoma in p...…”

Isolated Myeloid Sarcoma Presenting as Cord Compression by Paraspinal Mass

“…However, spinal cord invasion without a known pre-existing or concomitant diagnosis of hematologic diseases is rare [1,[3][4][5][6]. Here, we present an unusual case of myeloid sarcoma that showed spinal compression without bone marrow involvement.…”

“…Although any site of the body can be involved, the common locations are soft tissue, bone, periosteum, lymph nodes, peritoneum, and gastrointestinal A B Isolated, primary or nonleukemic myeloid sarcoma, defined by the absence of hematologic malignancies, is uncommon [3]. Only a few cases of isolated myeloid sarcoma have been presented with spinal involvement and cause spinal cord compression or cauda equine syndrome [6,7]. It is estimated that 13% to 19% of patients with isolated myeloid sarcoma had central nervous system involvement such as head or spinal cord involvement [7][8][9].…”