Cerebral myeloid sarcoma (Chloroma): Report of a rare entity

Myeloid sarcoma is a rare, malignant solid tumor composed of the progenitor cells of the myeloid lineage. Often associated with acute myeloid leukemia. Intracranial localization is very rare and diagnosis is confirmed by immunohistochemistry. The purpose of this case is to highlight the diagnostic and surgical treatment of a pathologically confirmed case of cerebral myeloid sarcoma.

We present the case of a 28-year-old Tunisian man who was diagnosed with AML in 2019, went into remission and was admitted to hospital with headaches and visual disturbances. Cranial MRI revealed an intra-axial parieto-occipital lesion on the left side. The patient underwent a successful surgical removal of the tumor. Immunohistochemistry confirms a cerebral myeloid sarcoma.

Myeloid sarcoma is a rare condition. It is mainly found on skin and soft tissue. Intracranial localization is very rare. The clinical presentation of myeloid sarcoma varies depending on the location of the lesion. Histochemistry studies are essential for accurate diagnosis. There is no consensus on the treatment of myeloid sarcoma and different treatment strategies have been used. Surgery plays a key role in alleviating the symptoms of the mass effect, in confirming the diagnosis and in removing the major lesions before initiating systemic therapy.

Cerebral myeloid sarcomas are uncommon. Intracranial mass should be strongly considered in acute myeloid leukemia patients. Conventional chemotherapy for AML is still the primary treatment for myeloid sarcomas, followed by surgery and possibly radiation.