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Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Teaching NeuroImages: sacral spine chloroma
Marc C Chamberlain1, Trent L Tredway, Donald Born
1From the Departments of Neurology (M.C.C.), Neurological Surgery (T.L.T.), Pathology (D.B.), and Radiology (J.F.), University of Washington, Seattle.
Neurology
|September 11, 2013
Summary
A rare chloroma, also known as myeloid sarcoma, presented as a paraspinal tumor in a patient with recurrent acute myeloid leukemia. This case highlights an unusual manifestation of myeloid sarcoma.
Area of Science:
- Hematology
- Oncology
- Neurology
Background:
- Acute myeloid leukemia (AML) can relapse, necessitating further treatment.
- Chloromas (myeloid sarcomas) are extramedullary tumors associated with myeloid neoplasms.
- While typically intracranial, chloromas can occur in paraspinal locations.
Observation:
- A patient in remission for acute myeloid leukemia developed buttock and thigh pain.
- Imaging revealed an S2 lesion, initially suspected to be a nerve sheath tumor.
- Biopsy confirmed the lesion as a chloroma (myeloid sarcoma).
Findings:
- This case represents an infrequent paraspinal manifestation of a chloroma.
- The patient had recurrent acute myeloid leukemia, a common association with chloromas.
- The chloroma was successfully treated with reinduction chemotherapy, irradiation, and allogeneic transplant.
Implications:
- Paraspinal chloromas can mimic other neurological conditions.
- Early diagnosis and treatment are crucial for managing this rare AML complication.
- This case underscores the importance of considering myeloid sarcoma in patients with AML and new neurological symptoms.
