title: Multiple intracranial de-novo chloromas presenting with Garcin's syndrome.
abstract: Intracranial occurrence of a chloroma (myeloid sarcoma, MS) in the absence of a preceding hematological malignancy is unusual. We report the case of a 20-year-old man who presented with Garcin's syndrome of short duration. MRI revealed multiple extra-axial contrast enhancing lesions: two mirror lesions on the skull base, and one in the right parietal convexity. The parietal lesion was excised and histologically and immunohistochemically proved to be a differentiated variant of MS. Peripheral blood smear and bone marrow biopsy ruled out an underlying leukemia or myeloproliferative disorder. With a diagnosis of intracranial de-novo MS, he was referred for chemotherapy and radiation therapy. 15 months later, his clinical status remained the same while his imaging showed marginal decrease in size of the lesions. A repeat bone marrow biopsy remained normal. This is a first-of-its- kind report of multiple intracranial lesions of a de-novo MS presenting as Garcin's syndrome. Radiological differentials, immunohistochemical variants and management options related to MS are discussed in the light of the reported case.
authors.affiliation: Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, EPIP Area, India. sumit.thakar@gmail.com
authors.forename: Sumit
authors.initials: S
authors.lastname: Thakar
authors.forename: Ravi
authors.initials: R
authors.lastname: Dadlani
authors.forename: Nandita
authors.initials: N
authors.lastname: Ghosal
authors.forename: Dilip
authors.initials: D
authors.lastname: Jethwani
authors.forename: Anita
authors.initials: A
authors.lastname: Mahadevan
authors.forename: Alangar S
authors.initials: AS
authors.lastname: Hegde
mesh_terms: D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology*; D003389:Cranial Nerve Diseases / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D023981:Sarcoma, Myeloid / Q000150:complications* / Q000473:pathology*; D013577:Syndrome; D055815:Young Adult