Skip to main content
SpringerLink
Log in

Meningeal Chloroma (granulocytic Sarcoma) in Acute Lymphoblastic Leukemia Mimicking a Falx Meningioma

  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Isolated chloromas (granulocytic sarcomas) are rare tumors. Chloromas are masses composed of immature granulocytic cells. Granulocytic sarcoma occurs primarily in patients with acute myelogenous leukemia and may also arise in patients with other myeloproliferative disorders, but rarely in patients with acute lymphoblastic leukemia (ALL). When dural-based, granulocytic sarcoma may be indistinguishable from meningioma radiologically. We now describe one patient affected by ALL with isolated granulocytic sarcoma mimicking a falx meningioma as initial CNS relapses. These unusual clinical manifestation and radiological finding in ALL should be considered as recurrence of leukemia. Early detection and antileukemic treatment of granulocytic sarcoma are necessarily important for favorable prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bleyer HW: Central nervous system leukemia. In: Henderson HS, Lister TA (eds) Leukemia. Saunders, Philadelphia, 1990, pp 207–224

    Google Scholar 

  2. Azzarelli B, Roessman U: Pathogenesis of central nervous system infiltration in acute leukemia. Arch Pathol Lab Med 191: 203–205, 1977

    Google Scholar 

  3. Sandhu GS, Gonzalez-Garcia J, Elexpuru-Camiruaga JA: Granulocytic sarcoma presenting as cauda equina syndrome. Clin Neurol Neurosurg 100: 205–208, 1998

    Google Scholar 

  4. Byrd JC, Edenfield WJ, Do NS, Ayleworth C, Dawson N: Extramedullary myeloid cell tumors in myelodysplastic syndromes: not a true indication of impending acute myeloid leukemia. Leuk Lymphoma 21: 153–159, 1996

    Google Scholar 

  5. Neiman RS, Barcos M, Berard C, Bonner H, Man R, Rydell RE, Bennett JM: Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer 48: 1426–1437, 1981

    Google Scholar 

  6. Quitt M, Kelner J, Sova J, Froom P, Aghai E: Accelerated phase of CML presenting with hypercalcemia and a mediastinal mass. Acta Haematol 99: 231–233, 1998

    Google Scholar 

  7. Stork JT, Digta OS, Schellinger D, Jackson RJ: Recurrent chloromas in acute myelogenous leukemia. AJR 142: 777–778, 1984

    Google Scholar 

  8. Pomerantz SJ, Hawkins HH, Towbin R, Lisberg WN, Clark RA: Granulocytic sarcoma (chloroma): CT manifestations. Radiology 155: 167–170, 1985

    Google Scholar 

  9. Imrie KR, Kovacs MJ, Selby D, Lipton J, Patterson BJ, Pantalony D, Poldre P, Ngan BY, Keating A: Isolated chloroma: the effect of early antileukemic therapy. Ann Int Med 123: 351–353, 1995

    Google Scholar 

  10. Frohna BJ, Quint DJ: Granulocytic sarcoma (chloroma) causing spinal cord compression. Neuroradiology 35: 509–511, 1993

    Google Scholar 

  11. Parker K, Hardjasudarma M, McClellan R, Fowler M, Milner J: MR features of an intracerebellar chloroma. Am J Neuroradiol 17: 1592–1594, 1996

    Google Scholar 

  12. Barnett MJ, Zussman WV: Granulocytic sarcoma of the brain: a case report and review of the literature. Radiology 160: 223–225, 1986

    Google Scholar 

  13. Kao SCS, Yuh TC, Sato Y, Barloon TJ: Intracranial granulocytic sarcoma (chloroma): MR findings. J Comput Assist Tomogr 11: 938–941, 1987

    Google Scholar 

  14. Sowers JJ, Moody DM, Naidich TP, Ball MR, Laster DW, Leeds NE: Radiographic features of granulocytic sarcoma (chloroma). J Comput Assist Tomogr 3: 226–233, 1979

    Google Scholar 

  15. Vinters HV, Gilbert JJ: Multifocal chloromas of the brain. Surg Neurol 17: 47–51, 1982

    Google Scholar 

  16. Walter AW, Hancock ML, Pui CH, Hudson MM, Ochs JS, Rivera GK, Pratt C, Boyett JM, Kun LE: Secondary brain tumors in children treated for acute lymphoblastic leukemia at St Jude Children's Research Hospital. J Clin Oncol 16: 3761–3767, 1998

    Google Scholar 

  17. Neglia P, Meadows AT, Robison LL, Kim TH, Newton WA, Ruymann FB, Sather HN, Hammond GD: Second neoplasms after acute lymphoblastic leukemia in childhood. N Engl J Med 325: 1330–1336, 1991

    Google Scholar 

  18. Stockl FA, Dolmetsch AM, Saornil MA, Font RL, Burnier MN Jr: Orbital granulocytic sarcoma. Br J Ophthalmol 81: 1084–1088, 1997

    Google Scholar 

  19. Bekassy AN, Hermans J, Gorin NC, Gratwohl A: Granulocytic sarcoma after allogeneic bone marrow transplantation: a retrospective European multicenter survey. Bone Marrow Transplant 17: 801–808, 1996

    Google Scholar 

  20. Meis JM, Butler JJ, Osborne BM, Mannig JT: Granulocytic sarcoma in nonleukemic patients. Cancer 58: 2697–2709, 1986

    Google Scholar 

  21. Huter O, Brezinka C, Nachbaur D, Schwaighofer H, Lang A, Niederwieser D: Successful treatment of primary extramedullary leukemia of the uterus with radical therapy, chemotherapy, autologous bone marrow transplantation and prophylactic local irradiation. Bone Marrow Transplant 18: 663–664, 1996

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Pundang CHA Hospital, Pochon University College of Medicine, Sungnam, South Korea

    Jung Yong Ahn, Seong Oh Kwon & Moon Soo Shin

  2. Department of Pediatrics, Pundang CHA Hospital, Pochon University College of Medicine, Sungnam, South Korea

    Shin Heh Kang & Young Rae Kim

Authors
  1. Jung Yong Ahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seong Oh Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Moon Soo Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shin Heh Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Young Rae Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ahn, J.Y., Kwon, S.O., Shin, M.S. et al. Meningeal Chloroma (granulocytic Sarcoma) in Acute Lymphoblastic Leukemia Mimicking a Falx Meningioma. J Neurooncol 60, 31–35 (2002). https://doi.org/10.1023/A:1020236031949

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1020236031949

Search

Navigation