Abstract
Acute myeloid leukemia (AML) is the most common malignancy in the acute leukemia category. AML is a very aggressive cancer with high mortality. The most common presentations include pancytopenia, bleeding, and recurrent infections. Unlike lymphoma, it rarely presents as a mass. Myeloid sarcoma is a peripheral collection of myeloid cells. Myeloid sarcoma most commonly involves the skin and gingival tissue and rarely it affects the central nervous system. Myeloid sarcoma involving the central nervous system is associated with high mortality. We present a patient with AML which evolved from myelofibrosis presented with acute spinal cord compression and found to have myeloid sarcoma involving the thoracic spinal cord. Despite acute radiation therapy, the patient could not recover her neurological function and passed away shortly after the diagnosis. We discuss the importance of early recognition of the complication due to myeloid sarcoma and treatment with neurosurgical intervention just like other mass causing acute cord compression.
Highlights
Primary myelofibrosis transformation into acute myeloid leukemia (AML) carries a very poor prognosis [1,2]
We present a patient who developed acute cord compression from myeloid sarcoma at the thoracic spine
Myeloid sarcoma is an extramedullary proliferation of blasts of leukemic cells that leads to disruption of the normal architecture of tissue in which it deposits
Summary
Primary myelofibrosis transformation into acute myeloid leukemia (AML) carries a very poor prognosis [1,2]. A small percentage of patients can present with prominent extramedullary diseases like myeloid sarcoma, myeloblastoma, or chloroma. We present a patient who developed acute cord compression from myeloid sarcoma at the thoracic spine. Bone marrow biopsy revealed 20% blasts with positive CD34 and CD117, suggestive of transformation to AML. Due to the critical condition of the patient and based on the oncologist’s suggestion that is most likely myeloid sarcoma, biopsy was deferred and the patient underwent emergent radiotherapy for thoracic lesion and started on chemotherapy. She did not recover her neurological function.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
