Diagnosis and treatment of a patient with isolated spinal granulocytic sarcoma: A case report

Xiao,Ruo‑Zhi; Long,Zi‑Jie; Xiong,Mu‑Jun; Wang,Wen‑Wen; Lin,Dong‑Jun

doi:10.3892/ol.2013.1203

Diagnosis and treatment of a patient with isolated spinal granulocytic sarcoma: A case report

Authors:
- Ruo‑Zhi Xiao
- Zi‑Jie Long
- Mu‑Jun Xiong
- Wen‑Wen Wang
- Dong‑Jun Lin
View Affiliations

Affiliations: Department of Hematology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China, Sun Yat‑sen Institute of Hematology, Sun Yat-sen University, Guangzhou, P.R. China
Published online on: February 19, 2013 https://doi.org/10.3892/ol.2013.1203
Pages: 1229-1232

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

A previously healthy 34‑year‑old female presented with a 5‑month history of progressive backache and weakness in the left fingers. Magnetic resonance imaging (MRI) showed soft tissue masses in the spinal canal distributed along the nerve course. The patient's baseline laboratory data were normal. Surgical intervention was performed and histological examination identified isolated spinal granulocytic sarcoma (GS). A bone marrow biopsy also presented normal findings. However, the patient developed numbness and pain in the right lower limb two months later. Fluorodeoxyglucose (FDG)‑positron emission tomography (PET) showed FDG uptake in the left trapezius muscle, cervix uteri, iliac bone, lymphadenectasis of the pelvic wall and left axillary fossa. Cerebrospinal fluid (CSF) examination allowed a diagnosis of central nervous system leukemia (CNSL). The patient underwent chemotherapy and intrathecal injection, resulting in the elimination of the residual lesion. Correct diagnosis and adequate treatment are essential to achieve optimal results in patients with isolated spinal GS.

View Figures

View References

1	Balleari E, Panarello S, Capello E, et al: Granulocytic sarcoma: an unusual cause of spinal cord compression. Int J Clin Oncol. 12:234–237. 2007. View Article : Google Scholar
2	Swerlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J and Vardiman JW: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th edition. IARC press; Lyon, France: 2008
3	Neiman RS, Barcos M, Berard C, et al: Granulocytic sarcoma: a clinicopathologic study of 61 biopsy cases. Cancer. 48:1426–1437. 1981. View Article : Google Scholar : PubMed/NCBI
4	Byrd JC, Edenfield WJ, Shields DJ and Dawson NA: Extramedullary myeloid cell tumors in acute non lymphocytic leukemia: a clinical review. J Clin Oncol. 13:1800–1816. 1995.PubMed/NCBI
5	Burns A: Observations on the Surgical Anatomy of the Head and Neck. 2nd edition. Wardlaw and Cunninghame; Glasgow, Scotland: pp. 386–387. 1824
6	King A: A case of chloroma. Monthly J Med. 17:971853.
7	Seok JH, Park J, Kim SK, Choi JE and Kim CC: Granulocytic sarcoma of the spine: MRI and clinical review. AJR Am J Roentgenol. 194:485–489. 2010. View Article : Google Scholar : PubMed/NCBI
8	Antic D, Verstovsek S, Elezovic I, et al: Spinal epidural granulocytic sarcoma in non-leukemic patient. Int J Hematol. 89:95–97. 2009. View Article : Google Scholar : PubMed/NCBI
9	Serefhanoglu S, Goker H, Aksu S, et al: Spinal myeloid sarcoma in two non-leukemic patients. Intern Med. 49:2493–2497. 2010. View Article : Google Scholar : PubMed/NCBI
10	Tsimberidou AM, Kantarjian HM, Estey E, et al: Outcome in patients with nonleukemic granulocytic sarcoma treated with chemotherapy with or without radiotherapy. Leukemia. 17:1100–1103. 2003. View Article : Google Scholar : PubMed/NCBI
11	Williams MP, Olliff JF and Rowley MR: CT and MR findings in parameningeal leukaemic masses. J Comput Assist Tomogr. 14:736–742. 1990. View Article : Google Scholar : PubMed/NCBI
12	Audouin J, Comperat E, Le Tourneau A, et al: Myeloid sarcoma: clinical and morphologic criteria useful for diagnosis. Int J Surg Pathol. 11:271–282. 2003. View Article : Google Scholar : PubMed/NCBI
13	Go KG, Pruim J, Que TH, Vaalburg W and Haaxma-Reiche H: Evaluation of dissemination studies with FDG whole-body positron emission tomography in patients with suspected metastatic tumours of brain and spine. Acta Neurochir (Wien). 142:627–631. 2000. View Article : Google Scholar : PubMed/NCBI
14	Imrie KR, Kovacs MJ, Selby D, et al: Isolated chloroma: the effect of early antileukemic therapy. Ann Intern Med. 123:351–353. 1995. View Article : Google Scholar : PubMed/NCBI
15	Lee JM, Song HN, Kang Y, et al: Isolated mediastinal myeloid sarcoma successfully treated with chemoradiotherapy followed by unrelated allogeneic stem cell transplantation. Intern Med. 50:3003–3007. 2011. View Article : Google Scholar
16	Stepensky P, Revel-Vilk S, Yehuda-Gafni O, Mali B, Resnick IB and Weintraub M: Isolated central nervous system granulocytic sarcoma and meningeal myeloid leukemia: successful treatment without radiotherapy. Isr Med Assoc J. 11:569–570. 2009.