Treatment Outcomes of Intracranial Myeloid Sarcomas: A Meta-Analysis

Lee, Dennis; Omofoye, Oluwaseun A.; Nuño, Miriam A; Riestenberg, Robert; Shahlaie, Kiarash

doi:10.1016/j.wneu.2021.01.004

Cited by 8 publications

(20 citation statements)

References 73 publications

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“…18 The histopathologic morphology exhibits myeloid cell infiltration, whereas immunohistochemical staining has been shown to have many positive biomarkers, especially CD34, CD43, CD68, and MPO. 9,18 The standard therapy for myeloid sarcoma involves treatment of the underlying neoplasia. 10 In adult patients with CNS involvement of AML, systemic therapy in addition to intrathecal chemotherapy and/or cranial irradiation is considered.…”

Section: Fig 2 Comparison Of T1-weighted Mri Of the Brain From 7 Years Prior (A) And Present T1-weighted Mri Of The Brain With Gadoliniummentioning

confidence: 99%

“…Surgery for decompression, which was lifesaving for our patient, has been reported in a minority of patients with CNS myeloid sarcoma. 1,9 In terms of prognosis, a review of 125 cases of CNS myeloid sarcoma reported complete resolution after therapy in 19.2% of patients. 1 The overall survival after diagnosis of CNS myeloid sarcoma in 94 patients ranged from a few days to 114 months (mean, 14 months).…”

Section: Fig 2 Comparison Of T1-weighted Mri Of the Brain From 7 Years Prior (A) And Present T1-weighted Mri Of The Brain With Gadoliniummentioning

confidence: 99%

“…To date, only a handful of case reports and small case series have described CNS myeloid sarcoma. 1,2,5,6,[9][10][11][12][13] We present a unique case of an adult male with AML in remission relapsing with an isolated, diffuse myeloid sarcoma of the cerebellum.…”

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confidence: 99%

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Isolated recurrence of acute myeloid leukemia in the cerebellum: illustrative case

Kohli

Koltz

Kamath

2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Myeloid sarcoma is a rare malignant hematopoietic neoplasm that arises at extramedullary sites. Although myeloid sarcoma may involve any organ, central nervous system (CNS) involvement is exceptionally rare. To date, few case reports and case series have described CNS myeloid sarcoma, the majority of which include peripheral disease. OBSERVATIONS The authors present an illustrative case of an adult male with acute myeloid leukemia (AML) in remission relapsing with an isolated, diffuse myeloid sarcoma of the cerebellum. Magnetic resonance imaging showed posterior fossa crowding and diffuse enhancement within the cerebellar white matter without an apparent mass lesion. The patient required ventriculostomy due to obstructive hydrocephalus and ultimately suboccipital craniectomy with duraplasty due to posterior fossa compression. An open cerebellar biopsy revealed myeloid sarcoma. Peripheral studies did not meet the criteria for recurrent AML. The patient subsequently received high-dose systemic chemotherapy and has responded well to treatment. LESSONS Myeloid sarcoma may be a neurosurgical lesion because it has the potential to cause mass effect with obstructive hydrocephalus requiring emergent cerebrospinal fluid diversion and possible decompression. The authors report a rare case of isolated recurrence of AML in the form of diffuse CNS myeloid sarcoma and describe the role of neurosurgery in its diagnosis and treatment.

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Section: Fig 2 Comparison Of T1-weighted Mri Of the Brain From 7 Years Prior (A) And Present T1-weighted Mri Of The Brain With Gadoliniummentioning

confidence: 99%

Section: Fig 2 Comparison Of T1-weighted Mri Of the Brain From 7 Years Prior (A) And Present T1-weighted Mri Of The Brain With Gadoliniummentioning

confidence: 99%

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Isolated recurrence of acute myeloid leukemia in the cerebellum: illustrative case

Kohli

Koltz

Kamath

2021

Journal of Neurosurgery: Case Lessons

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“…IMS is rare, with an estimated incidence of 0.4% in patients with AML and has a mixed prognosis with 84-month overall survival rate of 58.6%. [ 12 , 19 ] Leukemic cell infiltrates can migrate from the bone marrow into the underlying brain parenchyma, rarely resulting in intra-axial masses. [ 6 ] IMS most commonly presents with headache, vision changes, weakness, altered mental status, and nausea/vomiting of decreasing frequency of presentation.…”

Section: Introductionmentioning

confidence: 99%

“…[ 6 ] IMS most commonly presents with headache, vision changes, weakness, altered mental status, and nausea/vomiting of decreasing frequency of presentation. [ 12 ] The treatment of IMS depends on location, extent of systemic disease, age, and functional status of the patient. Although there are no established guidelines for treating IMS through large prospective randomized studies, the mainstay of treatment centers around radiotherapy or systemic chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Myeloid sarcoma of the skull base: A case report and systematic literature review

Athukuri¹,

Khan²,

Gadot³

et al. 2022

Surgical Neurology International

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Background: Myeloid sarcoma (MS), or chloroma, is a rare extramedullary malignant tumor that consists of undifferentiated granulocytic cells, and it is most commonly associated with acute myeloid leukemia (AML). Intracranial MS accounts for 0.4% of MS cases, and involvement of the skull base and visual dysfunction is rarely reported. However, the optimal treatment and response to treatment of skull base MS in the presence of visual symptoms is unknown. Case Description: A 30-year-old male with a history of AML presented with rapidly progressive vision loss and a sellar and parasellar mass with bilateral cavernous sinus and optic nerve encasement. The patient underwent endoscopic endonasal transsphenoidal biopsy revealing intracranial MS. He was treated postoperatively with high-dose intravenous and intrathecal cytarabine and had complete restoration of his vision by postoperative day 11. A systematic review of the literature identified six cases of skull base MS, five of whom presenting with visual symptoms. All patients underwent systemic chemotherapy with cytarabine and/or cyclophosphamide, with infrequent use of intrathecal chemotherapy or radiation. Those with reported visual outcomes were diagnosed 4 months or longer after symptom onset and demonstrated no visual improvement with treatment. Conclusion: Skull base MS is a rare disease entity with a high prevalence of visual dysfunction. Our patient’s complete disappearance of intracranial disease and resolution of visual symptoms with systemic and intrathecal chemotherapy highlight the importance of timely diagnosis and appropriate treatment without a need for direct surgical decompression.

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Isolated intracranial recurrence in a patient with long-term survival of acute myeloid leukemia

Huang¹,

Cao²,

Jiang³

et al. 2023

Asian Journal of Surgery

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Treatment Outcomes of Intracranial Myeloid Sarcomas: A Meta-Analysis

Cited by 8 publications

References 73 publications

Isolated recurrence of acute myeloid leukemia in the cerebellum: illustrative case

Isolated recurrence of acute myeloid leukemia in the cerebellum: illustrative case

Myeloid sarcoma of the skull base: A case report and systematic literature review

Isolated intracranial recurrence in a patient with long-term survival of acute myeloid leukemia

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