title: Pathological dislocation of the dorsal spine following granulocytic sarcoma in a non-leukaemic patient.
abstract: We describe a previously healthy, non-leukaemic young male presenting with neurological deficit and a pathological dislocation of D8 over D9 vertebra. The magnetic resonance imaging showed an enhancing soft tissue tumour. His basic laboratory workup as well as a bone marrow biopsy was normal. Through a single midline posterior approach, he underwent a decompressive laminectomy of D8 and D9 vertebra, anterior column reconstruction with a meshed titanium cage and posterior pedicle screw instrumentation. The histological diagnosis of granulocytic sarcoma was confirmed by appropriate immuno-histochemical studies. He received postoperative radiotherapy following which his wound dehiscesed and the tumour fungated and spread to his left thigh. He declined chemotherapy and unfortunately expired 9 months later. This case is presented to draw attention to the unusual presentation and to stress that granulocytic sarcoma should be kept in mind when making the differential diagnosis in patients with signs of spinal cord compression even in non-leukaemic individuals.
authors.affiliation: Spinal Disorders Services, Department of Orthopaedics Unit 1, Christian Medical College, Vellore, Tamil Nadu 632004, India. rohit@cmcvellore.ac.in
authors.forename: Rohit
authors.initials: R
authors.lastname: Amritanand
authors.forename: K
authors.initials: K
authors.lastname: Venkatesh
authors.forename: Anne J
authors.initials: AJ
authors.lastname: Premkumar
authors.forename: Gabriel D
authors.initials: GD
authors.lastname: Sundararaj
mesh_terms: D000293:Adolescent; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D016268:Internal Fixators; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008297:Male; D009362:Neoplasm Metastasis / Q000473:pathology / Q000503:physiopathology; D019635:Neurosurgical Procedures; D011859:Radiography; D023981:Sarcoma, Myeloid / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D013125:Spinal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
references.citation: Cancer. 1979 Sep;44(3):1017-21
references.pmid: 383264
references.citation: J Korean Med Sci. 1992 Sep;7(3):291-6
references.pmid: 1285931
references.citation: Cancer. 1973 Feb;31(2):423-32
references.pmid: 4510670
references.citation: Pathology. 2001 Aug;33(3):386-9
references.pmid: 11523946
references.citation: Acta Oncol. 1994;33(1):83-4
references.pmid: 8142136
references.citation: J Bone Joint Surg Br. 2008 Nov;90(11):1477-81
references.pmid: 18978269
references.citation: Neurol Med Chir (Tokyo). 2008 Mar;48(3):131-6
references.pmid: 18362461
references.citation: Neurosurgery. 1997 Jun;40(6):1283-7
references.pmid: 9179903
references.citation: J Bone Joint Surg Am. 1991 Oct;73(9):1402-4
references.pmid: 1918125
references.citation: Spine (Phila Pa 1976). 2005 Jun 1;30(11):E315-22
references.pmid: 15928542
references.citation: Neurosurgery. 2000 Jan;46(1):78-83; discussion 83-4
references.pmid: 10626938
references.citation: Cancer. 1986 Dec 15;58(12):2697-709
references.pmid: 3465429
references.citation: Neurol India. 2005 Jun;53(2):221-3
references.pmid: 16010065