203 - Spinal Myeloid Sarcoma “Chloroma” Presenting as Cervical Radiculopathy...

#203 Spinal Myeloid Sarcoma “Chloroma” Presenting as Cervical Radiculopathy: A Case Report

Spine Tumors

Poster Presented by: X. Hu

Author(s):

X. Hu (1)
I. Shahab (2)
I.H. Lieberman (1)

(1) Texas Back Institiute, Texas Health Presbyterian Hospital Plano, Scoliosis and Spine Tumor Center, Plano, TX, United States
(2) MD Pathology, Plano, TX, United States

Abstract

Introduction: Myeloid sarcoma also known as “chloroma”, is a rare extra-medullar tumor composed of immature granulocytic cells. It may occur early in the course of an acute or chronic leukemia or myeloproliferative disorders. Spinal cord invasion by myeloid sarcoma is rare.

Methods: A previously healthy 43 year old male presented with progressing neck, right shoulder and arm pain. Cervical MRI revealed a very large enhancing extradural soft tissue mass extending from C7 through T1 with severe narrowing of the thecal sac at T1 level (Figure 1). The patient underwent posterior cervical open biopsy, laminectomy and decompression. Histological examination of the surgical specimen confirmed the diagnosis of myeloid sarcoma. Postoperatively a bone marrow biopsy was done which showed myeloprilferative neoplasm with eosinophilia (Figure 2). The patient then received systemic chemotherapy and radiotherapy.

Results: At 10 months follow-up, the patient reported complete relief of arm pain and neck pain. X-rays showed that the overall cervical alignment was intact and there was no evidence of a recurrent lesion. MRI scan showed no evidence of compressive or remnant lesion.

Conclusions: Spinal myeloid sarcoma presenting as cervical radiculopathy is rare, and it may be easily misdiagnosed. Knowledge of its clinical presentation, imaging and histological characterization can lead to early diagnosis and appropriate treatment.

Figure 1

Figure 2