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ISSN 2225-4676 (Electronic)

2022, Number 2

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Rev Cubana Neurol Neurocir 2022; 12 (2)

Cervical spinal cord compression syndrome secondary to spinal epidural myeloid sarcoma

González PR, Arenas RIF, Martínez BY, Salinas OM, de Paula PA

Language: Spanish
References: 17
Page: 1-17
PDF size: 545.64 Kb.


ABSTRACT

Introduction: Myeloid sarcoma is a rare neoplastic condition characterized by the appearance of one or several tumor masses, consisting of immature myeloid cells in an extramedullary site. Its presentation in the central nervous system is very infrequent.
Objective: To describe the clinical, imaging and pathological characteristics that allowed the diagnosis of spinal epidural myeloid sarcoma.
Clinical case: A 24-year-old male patient, with a personal history of myopia, who had presented a left axillary furuncle two months earlier, came to the clinic due to cervical pain radiating to the upper limbs and spastic quadriparesis. The complete blood count showed leukocytosis with predominance of polymorphonuclear neutrophils and accelerated erythrocyte sedimentation rate. Magnetic resonance imaging of the cervical and dorsal spine showed an intraspinal extradural lesion in contact with the posterior face of the spinal cord from C3-T4. It was surgically approached posteriorly and a biopsy sample was taken. A medullogram and immunophenotype by flow cytometry were performed with results consistent with acute myeloid leukemia. Induction treatment with adriamycin and cytarabine was started. The biopsy of the cervical lesion revealed a myeloid sarcoma. There was slight initial improvement in neurological symptoms. On day 13 of treatment, the patient died as a result of hemorrhagic cerebrovascular disease.
Conclusions: Myeloid sarcoma was the cause of cervical spinal cord compression in this case, with no known history of hematological disease. It was diagnosed in the course of acute myeloid leukemia, complicating the treatment and prognosis of the patient.


REFERENCES

  1. Rodríguez E, Méndez A, Martínez J. Sarcoma Mieloide, una entidad poco frecuente. Revista Médica MD. 2019 [acceso 05/09/2021];10(3):245-9. Disponible en: https://medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=87216

  2. Magdy M, Karim NA, Eldessouki I, Gaber O, Rahouma M, Ghareeb M, et al. Myeloid Sarcoma. Oncol Res Treat. 2019;42:219-24. DOI: 10.1159/000497210.

  3. Kahn RM, Gordhandas S, Chapman E, Margolskee E, Matrai C, Chadburn A, et al. Acute Myeloid Leukemia Presenting as Myeloid Sarcoma with a Predisposition to the Gynecologic Tract. Hindawi Case Reports in Oncological Medicine. 2019:1-5. DOI: 10.1155/2019/4189275.

  4. Yang B, Yang C, Fang J, Jun Yang J, Xu Y. Clinicoradiological characteristics, management and prognosis of primary myeloid sarcoma of the central nervous system: A report of four cases. Oncology Letters. 2017;14:3825-31. DOI: 10.3892/ol.2017.6620.

  5. Avni B, Koren M. Myeloid sarcoma: current approach and therapeutic options. Ther Adv Hematol. 2011;2(5):309-16. DOI: 10.1177/2040620711410774.

  6. Saivignesh S, Brundha MP. Myeloid sarcoma. Int J Clinicopathol Correl. 2021;3:41-3. DOI: 10.4103/ijcpc.ijcpc_11_19.

  7. Kudva R, Monappa V, Solanke G, Valiathan M, Rao A, Geetha V, et al. Myeloid sarcoma: A clinicopathological study with emphasis on diagnostic difficulties. J Can Res Ther. 2021;13:989-93. DOI: 10.4103/0973-1482.220418.

  8. Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127:20. DOI: 10.1182/blood-2016-03-643544.

  9. Hwang SM. Classification of acute myeloid leukemia. Blood Res. 2020;55:1-4. DOI: 10.5045/br.2020.S001.

  10. Audouin J, Comperat E, Le Tourneau A, Camilleri‑Broët S, Adida C, Molina T, et al. Myeloid sarcoma: Clinical and morphologic criteria useful for diagnosis. Int J Surg Pathol. 2003;11(4):271‑82. DOI: 10.1177/106689690301100404.

  11. Kaur V, Swami A, Alapat D, Abdallah AO, Motwani P, Hutchins LF, et al. Clinical characteristics, molecular profile and outcomes of myeloid sarcoma: a single institution experience over 13 years. Hematology. 2018;23(1):17-24. DOI: 10.1080/10245332.2017.1333275.

  12. Meyer HJ, Beimler M, Borte G, Pönisch W, Surov A. Radiological and clinical patterns of myeloid sarcoma. Radiol Oncol. 2019;53(2):213-8. DOI: 10.2478/raon-2019-0014.

  13. Meyer HJ, Pönisch W, Schmidt SA, Wienbeck S, Braulke F, Schramm D, et al. Clinical and imaging features of myeloid sarcoma: a German multicenter study. BMC Cancer. 2019;19:1150. DOI: 10.1186/s12885-019-6357.

  14. Hou X, Du L, Yu H, Zhang X. Use of magnetic resonance imaging for diagnosis and after treatment of patients with myeloid sarcoma of the brain. Oncotarget. 2017 [acceso 05/09/2021];8(60):102581-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731983/

  15. Pokharel A, Rao TS, Basnet P, Pandey B, Mayya NJ, Jaiswal S, et al. Extradural cervical spinal schwannoma in a child: a case report and review of the literature. Journal of Medical Case Reports. 2019;13:230. DOI: 10.1186/s13256-019-2108-6.

  16. Álvarez S, Piña KM, Rial JC. Extradural en-plaque spinal lipomatous meningioma: A case report and literature review. Sur Neur Int. 2019;10(49). DOI: 10.25259/SNI-87-2019

  17. Lai AL, Salkade PR, Chuah KL, Sitoh YY. Extradural cervical spinal meningioma mimicking malignancy. Radiology Case. 2018;12(10):1-10. DOI: 10.3941/jrcr.v12i10.3498




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