Abstract
Myeloid sarcomas (MS) preceding acute myeloid leukemia (AML) are rare, which presenting as acute spinal cord compression is even rare. Here we report two new cases of myeloid sarcoma patients, whose outcomes were different. Twenty-seven patients with spinal MS preceding AML have been reported to date, including the two cases presented in this article. Surgical decompression was performed in 25 of the 27 patients, and 23 of these received additional anti-AML therapy. Considering our patients and the published cases in the literature we suggest that immunohistochemical study plays an essential role in arriving at a correct diagnosis of MS, and that emergency surgery to resect spinal MS is an available treatment to make neural function recovery, and that the disease must be treated with intensive chemotherapy similar to that used to treat AML as soon as possible after resection or irradiation of the tumor.
Similar content being viewed by others
References
Brunning RD, Matutes E, Fladrin G, et al. Acutemyeloid leukaemia not otherwise categorised. In: Jaffe ESHN, Stein H, Vardiman JW, editors. World Health Organization classification of tumors. Pathology and genetics of tumors of haematopoietic and lymphoid tissues[D]. Lyon: IARC Press, 2001; 104–5.
Shiozawa Y, Kiyokawa N, saito M, et al. Granuocytic sarcoma of the spine in a child without bone marrow involvement: a case report and literature review[J]. Eur J Pediatr 2005; 164: 616–20.
Yamauchi K, Yasuda M. Comparison in treatments of nonleukemic granulocytic sarcoma: report of two cases and a review of 72 cases in the literature[J]. Cancer 2002; 94:1739–46.
Tsimberidou AM, Kantarjian HM, Wen S, et al. Myeloid sarcoma is associated with superior event-free survival and overall survival compared with acute myeloid leukemia[J]. Cancer 2008; 113: 1370–8.
Buckland ME, Scolyer RA, Donellan MB, et al. Spinal chloroma presenting with triplegia in an aleukaemic patient[J]. Pathology 2001; 33: 386–9.
Chan JK, Lau WH, Saw D. Extradural granulocytic sarcoma of the spine: a unique case of long survival after local therapy[J]. Am J Hematol 1986; 22: 439–41.
Doshi HM, Schochet SS Jr, Gold M, et al. Granulocytic sarcoma presenting as an epidural mass with acute paraparesis in an aleukemic patient[J]. Am J Clin Pathol 1991; 95: 228–32.
Deme S, Deodhare SS, Tucker WS, et al. Granulocytic sarcoma of the spine in nonleukemic patients: report of three cases[J]. Neurosurgery 1997; 40: 1283–7.
Hamadani M, Tfayli A, Sethi S, et al. Granulocytic sarcoma manifesting as multiple skeletal lesions[J]. Am J Med Sci 2005; 330: 139–43.
Howell DL, Abramowsky CR. Granulocytic sarcoma presenting as a large mediastinal mass with acute spinal cord compression in a non-leukemic child[J]. Pediatr Blood Cancer 2005; 44: 527.
Kim FS, Rutka JT, Bernstein M, et al. Intradural granulocytic sarcoma presenting as a lumbar radiculopathy. Case report[J]. J Neurosurg 1990; 72: 663–7.
Kook H, Hwang TJ, Choe K, et al. Spinal epidural granulocytic sarcoma preceding acute myelogenous leukemia[J]. J Korean Med Sci 1992; 7: 291–6.
Kalayci M, Sumer M, Yenidunya S, et al. Spinal granulocytic sarcoma (chloroma) presenting as acute cord compression in a nonleukemic patient[J]. Neurol India 2005; 53: 221–3.
Lagrange M, Gaspard MH, Lagrange JL, et al. Granulocytic sarcoma with meningeal leukemia but no bone marrow involvement at presentation. A report of two cases with characteristic cerebrospinal fluid cytology[J]. Acta Cytol 1992; 36: 319–24.
Meis JM, Butler JJ, Osborne BM, et al. Granulocytic sarcoma in nonleukemic patients[J]. Cancer 1986; 58: 2697–709.
Mason TE, Demaree RS Jr, Margolis CI. Granulocytic sarcoma (chloroma), two years preceding myelogenous leukemia[J]. Cancer 1973; 31: 423–32.
McCarty KS Jr, Wortman J, Daly J, et al. Chloroma (granulocytic sarcoma) without evidence of leukemia: facilitated light microscopic diagnosis[J]. Blood 1980; 56: 104–8.
Mostafavi H, Lennarson PJ, Traynelis VC. Granulocytic sarcoma of the spine[J]. Neurosurgery 2000; 46: 78–84.
Machii R, Muto A, Okano Y, et al. Granulocytic sarcoma presenting as an epidural mass with spinal cord compression[J]. Rinsho Ketsueki 2000; 41: 653–7.
Niedermayer I, Schmitt-Graeff A, Kolbel CB, et al. Granulocytic sarcoma (so-called chloroma) as a possible cause of spinal cord compression. Case report and differential diagnosis[J]. Pathologe 2000; 21: 82–5.
Ripp DJ, Davis JW, Rengachary SS, et al. Granulocytic sarcoma presenting as an epidural mass with cord compression[J]. Neurosurgery 1989; 24: 125–8.
Alexiev BA, Wang W, Ning Y. Myeloid sarcomas: a histologic, immunohistochemical, and cytogenetic study[J]. Diagn Pathol 2007; 2: 42.
Sajjad Z, Haq N, Kandula V. Case report: granulocytic sarcoma (GS) presenting as acute cord compression in a previously undiagnosed patient[J]. Clin Radiol 1997; 52: 69–71.
Sandhu GS, Ghufoor K, Gonzalez-Garcia J, et al. Granulocytic sarcoma presenting as cauda equina syndrome[J]. Clin Neurol Neurosurg 1998; 100: 205–8.
Inoue T, Takahashi T. Spinal granulocytic sarcoma manifesting as radiculopathy in a nonleukemic patient[J]. Neurol Med Chir 2008; 48:131–6.
Ugras S, Cirak B, Karakok M, et al. Spinal epidural granulocytic sarcoma (chloroma) in a non-leukemic child[J]. Pediatr Int 2001; 43: 505–7.
Zuiable A, Aboud H, Nandi A, et al. Extramedullary disease initially without bone marrow involvement in acute promyelocytic leukaemia[J]. Clin Lab Haematol 1989; 11: 288–9.
Cartwright RA, Gurney KA, Moorman AV. Sex ratios and the risks of haematological malignancies[J]. Br J Haematal 2002; 118:1071–7.
Widhalm G, Dietrich W, Mullauer L, et al. Myeloid sarcoma with multiple lesions of the central nervous system in a patient without leukemia. Case report[J]. J Neurosurg 2006; 105: 916–9.
Landis DM, Aboulafia DM. Granulocytic sarcoma: an unusual complication of aleukemic myeloid leukemia causing spinal cord compression. A case report and literature review[J]. Leuk Lymphoma 2003; 44: 1753–60.
Colella G, Tirelli A, Capone R, et al. Myeloid sarcoma occuring in the maxillary gingiva: a case without leukemic manifestations[J]. Int J Hematol 2005; 81: 138–41.
Zekry N, Klooster MJ, Raghavan R, et al. A 7-year-old child with a history of acute myeloid leukemia presenting with multiple gastrointestinal polyps[J]. Arch Pathol Lab Med 2006; 130: 3–4.
Li JM, Liu WP, Zhang MH, et al. Clinicopathologic and immunophenotypic analysis of myeloid sarcoma[J]. Zhonghua Bing Li Xue Za Zhi(in Chinese) 2006; 35: 606–11.
Liu YH, Zhuang HG, Liao XB, et al. Diagnosis and differential diagnosis of granulocytic sarcomas[J]. Zhonghua Xue Ye Xue Za Zhi (in Chinese) 2003; 24: 568–71.
Chang CC, Eshoa C, Kampalath B, et al. Immunophenotypic profile of myeloid cells in granulocytic sarcoma by immunohistochemistry. Correlation with blast differentiation in bone marrow[J]. Am J Clin Pathol 2000; 114: 807–11.
Hudock J, Chatten J, Miettinen M: Immunohistochemical evaluation of myeloid leukemia infiltrates (granulocytic sarcomas) in formaldehyde-fixed, paraffin-embedded tissue[J]. Am J Clin Pathol 1994; 102: 55–60.
Traweek ST, Arber DA, Rappaport H, et al. Extramedullary myeloid cell tumors. An immunohistochemical and morphological study of 28 cases[J]. Am J Surg Pathol 1993; 17: 1011–9.
Menasce LP, Banerjee SS, Beckett E, et al. Extramedullary myeloid tumor (granulocytic sarcoma) is often misdiagnosed: a study of 26 cases[J]. Histopathol 1999; 34: 391–8.
Garcia MG, Deavers MT, Knoblock RJ, et al. Myeloid sarcoma involving the gynecologic tract: a report of 11 cases and review of the literature[J]. Am J Clin Pathol 2006; 125: 783–90.
Muss HB, Moloney WC. Chloroma and other myeloblastic tumors[J]. Blood 1973; 42: 721–8.
Imrie KR, Kovacs MJ, Selby D, et al. Isolated chloroma: the effect of early antileukemic therapy[J]. Ann Intern Med 1995; 123: 351–3.
Stevenson WS, Vincent PC, Iland HJ. Disseminated granulocytic sarcoma treated with allogeneic peripheral blood stem-cell transplantation[J]. Leuk Lymphoma 2002; 43: 2221–4.
Author information
Authors and Affiliations
Corresponding author
Additional information
Contributed equally to this study.
Rights and permissions
About this article
Cite this article
Yin, Q., Zhou, Yy., Chen, D. et al. Different outcome of myeloid sarcoma with spinal cord compression preceding acute myeloid leukemia: Report of two cases and review of literatures. Chin. J. Cancer Res. 22, 156–162 (2010). https://doi.org/10.1007/s11670-010-0156-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11670-010-0156-y