Granulocytic Sarcoma with Long Spinal Cord Compression: A Case Report

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.