Spinal epidural granulocytic sarcoma in non-leukemic patient

Area of Science:

• Oncology
• Neurology
• Pathology

Background:

• Granulocytic sarcoma (GS), a rare extramedullary tumor of myeloid blasts, can present as an isolated finding without bone marrow involvement.
• Early diagnosis and comprehensive treatment are crucial for managing GS, particularly in cases presenting with neurological deficits.

Observation:

• A 24-year-old male with no prior health issues developed progressive backache and leg weakness over three months.
• Spinal MRI revealed a large paraspinal soft tissue mass in the lumbosacral region, infiltrating vertebrae and extending into the spinal canal and pelvis.
• Initial laboratory results were normal, and bone marrow biopsy showed no abnormalities.

Findings:

• Surgical decompression and tumor removal resulted in neurological improvement.
• Histopathological examination confirmed the diagnosis of granulocytic sarcoma (GS).
• The patient received adjuvant chemotherapy, radiotherapy, and autologous stem cell transplant, leading to complete remission.

Implications:

• This case underscores the importance of considering isolated granulocytic sarcoma in the differential diagnosis of spinal masses presenting with neurological symptoms.
• Multimodal treatment including surgery, chemotherapy, radiotherapy, and stem cell transplant can achieve favorable outcomes in patients with isolated GS.
• Early and accurate diagnosis followed by aggressive, systematic treatment is essential for optimal patient prognosis and disease eradication.