Spinal cord compression in an adolescent with relapsed B-precursor acute lymphoblastic leukemia and mental neuropathy

The authors report a case of intraspinal mass associated with recurrence of B-precursor acute lymphoblastic leukemia in an adolescent male who presented with numb chin syndrome at initial diagnosis of the leukemia. The patient developed sensory changes, later on motor weakness, and eventually paraplegia. An emergent MRI scan showed an intraspinal mass at the level of T9 vertebra. Biopsy obtained during laminectomy revealed a mass composed of lymphoblasts immunophenotypically identical to the patient's known leukemia. Surgical decompression and dexamethasone were ineffective in restoration of the neurological deficits. Intraspinal extramedullary relapses should be considered in the differential diagnosis of leukemic patients with neurological symptoms.