title: Spinal epidural granulocytic sarcoma in a child precedent to clinical manifestation of acute myeloid lymphoma: case report.
abstract: A 13-year-old boy presented with an epidural thoracic granulocytic sarcoma manifesting as rapidly progressive paraplegia preceding clinical manifestation of acute myeloid leukemia (AML). Magnetic resonance imaging revealed a thoracic epidural tumor. He underwent emergent laminectomy and the tumor was totally resected. The initial histological diagnosis was malignant lymphoma. The correct diagnosis of epidural granulocytic sarcoma and AML was established based on cell-surface markers and a chromosomal study of the bone marrow cells. A combination of chemotherapy and bone marrow transfusion achieved complete remission of leukemia. No evidence of AML has emerged over the 18-month follow-up period. Granulocytic sarcoma should be considered in the differential diagnosis of an epidural mass in pediatric patients with or without acute leukemia. Immediate diagnosis and appropriate treatment are recommended to prevent leukemic transformation.
authors.affiliation: Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. tkdmsk@hiroshima-u.ac.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Kuniki
authors.initials: K
authors.lastname: Eguchi
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Kajiume
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nishimura
authors.forename: Masao
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kurisu
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D015174:Epidural Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D005094:Exophthalmos / Q000209:etiology; D006801:Humans; D007796:Laminectomy; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009915:Orbit / Q000473:pathology; D010264:Paraplegia / Q000209:etiology; D012074:Remission Induction; D023981:Sarcoma, Myeloid / Q000601:surgery*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D013702:Temporal Lobe / Q000473:pathology; D013904:Thoracic Vertebrae / Q000601:surgery
chemical_list: D008775:Methylprednisolone