Granulocytic Sarcoma Presenting as Epidural Mass in Lumbosacral Spine: A Case Report

ABSTRACT

Granulocytic sarcoma, as known as chloroma, is a localized solid tumor consisting of immature myeloid cells. It is a infrequent extramedullary manifestation of acute or chronic leukemias and can often precede their bone marrow involvement. Spinal involvement of granulocytic sarcoma is very rare. A 17-year-old man presented with low back pain, gluteal pain and perianal numbness for 1 month. Lumbar spine magnetic resonance imaging (MRI) was taken under impression of herniated lumbar intervertebral disc and showed an epidural mass at the lumbosacral spinal canal. Leukocytosis, thrombocytopenia and anemia were found on blood cell count. Excisional biopsy of mass was done and the histopathologic examination confirmed the diagnosis of granulocytic sarcoma. Subsequent bone marrow biopsy revealed myelodysplastic syndrome. He had received anti-leukemic chemotherapy and the size of lumbosacral mass was markedly decreased. As a granulocytic sarcoma of spinal column is uncommon, high index of suspicion is inevitable to diagnose it. Therefore it must be included as a differential diagnosis of spinal epidural mass.