Granulocytic sarcoma, an undiagnosed leukemia, initially manifested as paralysis

Area of Science:

• Oncology
• Hematology
• Neurology

Background:

• Granulocytic sarcoma (GS) is an extramedullary tumor of myelocytic precursors.
• GS can be a presenting sign of myelogenous leukemia or occur in non-leukemic patients.
• Spinal cord GS can rarely manifest as the initial symptom of undiagnosed leukemia, leading to paralysis.

Observation:

• A case report of a 20-year-old female presenting with paralysis due to spinal cord GS is detailed.
• The patient had undiagnosed leukemia at the time of presentation.
• The tumor was surgically removed via en bloc spondylectomy.

Findings:

• En bloc spondylectomy followed by chemotherapy was the chosen treatment.
• The patient received two courses of postoperative chemotherapy.
• Significant improvement in bilateral lower extremity function was observed post-treatment.

Implications:

• This case highlights the importance of considering leukemia in young patients with spinal cord GS presenting with paralysis.
• Prompt diagnosis and multimodal treatment (surgery and chemotherapy) are crucial for favorable outcomes.
• Early detection and intervention can potentially reverse neurological deficits caused by spinal cord GS in leukemia.