Spinal Myeloid Sarcoma Revealing Acute Myeloid Leukemia in a Child: A Case Report

Myeloid sarcoma (MS), formerly known as chloroma or granulocytic sarcoma, is a rare extramedullary malignant tumor composed of immature myeloid precursor cells. It is most commonly associated with acute myeloid leukemia (AML), although it may also occur in the setting of myelodysplastic syndromes or chronic myeloid leukemia, and occasionally precedes the diagnosis of systemic hematologic disease. Owing to its diverse clinical manifestations and non-specific radiological findings, diagnosis remains challenging and is frequently delayed. We report the case of an eight-year-old boy with no significant medical history who presented with a two-week history of dorsal back pain, asthenia, and progressive weakness of the lower limbs, followed by acute urinary and fecal incontinence. Clinical examination revealed acute flaccid paraplegia associated with thoracic spinal tenderness. Spinal magnetic resonance imaging (MRI) demonstrated an epidural mass causing spinal cord compression. Histopathological and immunohistochemical analyses confirmed the diagnosis of myeloid sarcoma. Further investigations established the diagnosis of AML-M2. The patient received systemic chemotherapy according to an AML treatment protocol, resulting in favorable neurological and clinical improvement.