Shao YD, Wang XH, Sun L, Cui XG. Granulocytic sarcoma with long spinal cord compression: A case report. World J Clin Cases 2022; 10(31): 11536-11541 [PMID: 36387816 DOI: 10.12998/wjcc.v10.i31.11536]
Corresponding Author of This Article
Xin-Gang Cui, MD, PhD, Chief Physician, Professor, Department of Spine Surgery, Shandong Provincial Hospital, Shandong University, No. 9677 Jingshi Road, Jinan 250000, Shandong Province, China. spine2014@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2022; 10(31): 11536-11541 Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11536
Granulocytic sarcoma with long spinal cord compression: A case report
Yuan-Dong Shao, Xue-Hua Wang, Lei Sun, Xin-Gang Cui
Yuan-Dong Shao, Xin-Gang Cui, Department of Spine Surgery, Shandong Provincial Hospital, Shandong University, Jinan 250000, Shandong Province, China
Yuan-Dong Shao, Xue-Hua Wang, Lei Sun, Department of Spine Surgery, Binzhou People’s Hospital, Binzhou 256600, Shandong Province, China
Author contributions: Shao YD reviewed the literature and contributed to manuscript drafting; Wang XH and Sun L were responsible for data collection and analysis; Cui XG was responsible for the revision of the manuscript; and all authors issued final approval for the version to be submitted.
Supported byShandong Medical and Health Science and Technology Development Plan Project, No. 202004071188; Shandong Province Traditional Chinese Medicine Science and Technology Project, No. M-2022133; Practical Teaching Reform and Research Project of Binzhou Medical College, No. SJJY201927; Scientific Research Project of Affiliated Hospital of Binzhou Medical College, No. BY2020KJ74; the National Natural Science Foundation of China, No. 82002325; and the Natural Science Foundation of Shandong Province, No. ZR2020QH075, ZR2021MH167 and ZR2021LZY004.
Informed consent statement: Informed written consent was obtained from the patient’s guardian for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Gang Cui, MD, PhD, Chief Physician, Professor, Department of Spine Surgery, Shandong Provincial Hospital, Shandong University, No. 9677 Jingshi Road, Jinan 250000, Shandong Province, China. spine2014@163.com
Received: June 7, 2022 Peer-review started: June 7, 2022 First decision: August 4, 2022 Revised: August 17, 2022 Accepted: September 27, 2022 Article in press: September 27, 2022 Published online: November 6, 2022 Processing time: 138 Days and 20.9 Hours
Abstract
BACKGROUND
As an extramedullary form of proliferating myeloblasts, granulocytic sarcoma (GS) is common in patients with acute myeloid leukemia. GS in the central nervous system is rare, and an intraspinal space-occupying lesion caused by GS is even rarer. Surgical decompression is often necessary to remove the intraspinal space-occupying lesion. To the best of our knowledge, we report, for the first time a case of GS that caused extensive compression in the spinal canal without surgical decompression treatment.
CASE SUMMARY
A 15-year-old male suddenly developed numbness and weakness in his lower limbs for 10 d, which affected his walking ability. Acute myeloid leukemia was later diagnosed in the Department of Hematology. Magnetic resonance imaging revealed that multiple segmental space-occupying lesions were causing severe spinal cord compression in the thoracic spinal canal. As a result, the patient received routine chemotherapy before surgery. Interestingly, the intraspinal space-occupying lesions completely diminished on magnetic resonance imaging after a course of chemotherapy, and the sensation and strength in his lower limbs markedly recovered.
CONCLUSION
An intraspinal space-occupying lesion could be the first symptom of acute myeloid leukemia, causing spinal nerve compression without any other symptoms. Following standard chemotherapy, spinal canal compression can be quickly relieved, and the spinal cord and nerve function restored, avoiding emergency surgery.
Core Tip: This case is important as not all intraspinal granulocytic sarcoma in acute myeloid leukemia or chronic myeloid leukemia appear after systemic symptoms. We suggest that if conditions permit, relief of spinal cord compression can be achieved by standard chemotherapy. However, if hematological diseases are excluded, emergency surgery or biopsy is necessary to preserve the spinal cord and nerve function.
