J Korean Soc Spine Surg.  2010 Mar;17(1):33-37. 10.4184/jkss.2010.17.1.33.

Epidural Granulocytic Sarcoma presenting as Thoracic Spinal Cord Compression: Case Report

• Shin DE
• Ahn CS
• Chung SY
• Lee IS

• KMID: 2003097
• DOI: http://doi.org/10.4184/jkss.2010.17.1.33

Abstract

STUDY DESIGN: A case report
OBJECTIVES
This case report presents a patient with thoracic spinal cord compression, who had been on regular follow-up after being diagnosed with myelodysplastic syndrome. SUMMARY OF LITERATURE REVIEW: A granulocytic sarcoma is a rare tumor that occurs in the extramedullary sites, forming a localized lesion with a predilection in the orbit, sinus and periosteum. It rarely involves the central nervous system, particularly spinal cord. MATERIAL AND METHODS: For myelodysplastic syndrome, the patient underwent a bone marrow transplant for the condition. He was placed on conservative treatment until he developed sudden abdominal pain. He was admitted to our hospital through the emergency department. On the 2nd hospital day he complained of increasing weakness in his lower extremities. He underwent an emergency decompression of the spinal cord and his motor weakness completely disappeared.
RESULTS
No signs of recurrence were found on the follow up performed at 2 years and 6 months.
CONCLUSION
Epidural granulocytic sarcoma is rare but can be treated successfully.

Keyword

Epidural granulocytic sarcoma; Thoracic spine

MeSH Terms

Abdominal Pain
Bone Marrow
Central Nervous System
Decompression
Emergencies
Emergency Service, Hospital
Follow-Up Studies
Humans
Lower Extremity
Myelodysplastic Syndromes
Orbit
Periosteum
Recurrence
Sarcoma, Myeloid*
Spinal Cord
Spinal Cord Compression*

Figure

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  Fig. 1. Magnetic resonance imaging showing epidural tumor compressing thoracic spinal cord. (A) T-1 weighted saggital and axial images showing epidural tumor compressing thoracic spinal cord. (B) T-2 weighted saggital and axial images showing epidural tumor compressing thoracic spinal cord T1 & T2.

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  Fig. 2. Immediate postoperative x-rays after total laminectomy and posterior instrumentation. (A) AP view. (B) Lateral view.

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  Fig. 3. Gross and microscopic photographs. Infiltrate consists of atypical round cells suggestive of myeloid origin, with cells varying in size and morphology showing vesicular nuclei, prominent nucleoli, and a few mitotic figures[H&E stain, original magnification ×400]

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  Fig. 4. Immunohistochemical staining showed expression (brown) of myeloperoxidase, C-kit, and TdT. [original magnification ×400]

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