Paraplegia due to involvement of a long segment of the spinal cord: A rare presentation of chronic myeloid leukemia in blast crises

Abstract

Chronic myeloid leukemia is the most common myeloproliferative neoplasm and very rarely presents upfront with involvement of central nervous system. Here we present a peculiar case of a 34 year old male who presented with complaints of rapidly progressive weakness of both the lower limbs of 2 week duration. On examination it was found to be upper motor neuron type of sensory motor paraplegia with bladder and bowel involvement. The upper level of sensory involvement was at D-6. On further investigations his total leucocyte counts were very high and he was diagnosed as a case of chronic myeloid leukemia in chronic phase. MRI scan of spine was suggestive of extensive involvement of spinal cord from D2-L3 level causing compression over thecal sac & spinal cord leading to the above mentioned complains. Biopsy from the lesion was suggestive of collection of extramedullarly blasts.