Myeloid sarcoma with multiple lesions of the central nervous system in a patient without leukemia. Case report.
The authors report the unusual case of a 35-year-old woman suffering from left leg numbness and radiculopathy due to multiple lesions in the central nervous system: one right parietal extracranial-intracranial lesion with invasion of the sensory cortex, and two intraspinal, intradural lesions compressing the spinal cord at T3-5 and S 1-4. Biopsy sampling of the extracranial part of the parietal lesion led to a diagnosis of myeloid sarcoma. Further examination revealed no evidence of leukemic disease or myeloproliferative disorder. An aggressive multimodal approach to treatment in this patient with a combination of chemotherapy, whole-body radiotherapy, and allogeneic bone marrow transplantation was started immediately. The patient experienced full neurological recovery and complete disappearance of all lesions. At the 7-year follow-up examination, there was no evidence of disease. To the authors' knowledge, this is the first report of a myeloid sarcoma with both intracranial and intraspinal manifestations in a patient without leukemia.
Widhalm
Georg
G
Department of Neurosurgery, Medical University of Vienna, Austria. georg.widhalm@meduniwien.ac.at
Dietrich
Wolfgang
W
Müllauer
Leonhard
L
Streubel
Berthold
B
Rabitsch
Werner
W
Kotter
Mark R
MR
Knosp
Engelbert
E
Roessler
Karl
K
D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D023981:Sarcoma, Myeloid / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012888:Skull Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013003:Somatosensory Cortex / Q000473:pathology*; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed