Non-leukemic myeloid sarcomas involving only the central nervous system: a case report and literature review

A previously healthy 39-year-old male presented with a five-month history of dizziness and progressive numbness and weakness of the lower limbs for more than two months. Contrast-enhanced MRI revealed multiple enhancing soft tissue masses in the spinal canal, while PET/CT indicated numerous hypermetabolic lesions in the intracranial and spinal regions. Initial pathological findings suggested inflammatory lesions, and the diagnosis remained uncertain after consultations at multiple hospitals. The patient was admitted to our hospital on June 15, 2019. Subsequent examinations after admission ruled out tuberculosis infection. A lumbar puncture was performed, and cerebrospinal fluid was collected for cytological examination, revealing numerous abnormal cells. We suspected the presence of a tumor. After intrathecal chemotherapy, the patient's symptoms showed some improvement; however, subsequent imaging revealed progression of the intracranial lesions accompanied by cerebral herniation. A repeat surgical biopsy suggested myeloid sarcoma (MS). The patient was transferred to a cancer hospital for chemotherapy but succumbed to the critical illness on September 16, 2019. Through this case report, we hope to gain a better understanding of myeloid sarcoma. Timely diagnosis and appropriate treatment are essential for obtaining the desired results.