Granulocytic sarcoma presenting as presenting as monoparesis: A rare case report

Area of Science:

• Oncology
• Hematology
• Neurology

Background:

• Granulocytic sarcomas (GSs), also known as myeloid sarcomas or chloromas, are uncommon extramedullary tumor masses composed of immature granulocytic cells.
• These tumors are associated with acute myelogenous leukemia, chronic myelogenous leukemia (CML), and other myeloproliferative neoplasms.
• GSs are rarely the initial presenting manifestation of an underlying myeloproliferative disorder.

Observation:

• A 35-year-old male presented with monoparesis.
• Imaging revealed a cervical intradural extramedullary mass with an extradural extension.
• Initial presentation lacked overt signs of leukemia, but subsequent investigations identified chronic myeloid leukemia.

Findings:

• Histopathological examination of the resected mass confirmed it as a granulocytic sarcoma.
• Bone marrow studies and blood work confirmed the diagnosis of chronic myeloid leukemia.
• The case illustrates a rare instance of GS as the first clinical sign of CML.

Implications:

• This case underscores the importance of considering granulocytic sarcoma in the differential diagnosis of spinal masses, even in the absence of typical leukemia symptoms.
• Early recognition and diagnosis of GS can lead to timely initiation of treatment for the underlying myeloproliferative neoplasm.
• Further research into the early diagnostic markers and management strategies for GS as an initial presentation of CML is warranted.