Liquid Presenting as Solid: A Rare Presentation of Acute Myeloid Leukaemia as a Solid Epidural Mass

Varsha Gupta; Firas Ajam; Gabriella Conte; Alsadiq Al Hillan; Kadhim Al-Banaa; Vinit Singh; Michael Levitt

doi:10.12890/2020_001802

Liquid Presenting as Solid: A Rare Presentation of Acute Myeloid Leukaemia as a Solid Epidural Mass

Eur J Case Rep Intern Med. 2020 Sep 8;7(11):001802. doi: 10.12890/2020_001802. eCollection 2020.

Authors

Varsha Gupta¹, Firas Ajam¹, Gabriella Conte¹, Alsadiq Al Hillan¹, Kadhim Al-Banaa², Vinit Singh³, Michael Levitt⁴

Affiliations

¹ Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA.
² Department of Medicine, Beaumont Hospital, Dearborn, MI, USA.
³ Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, CT, USA.
⁴ Division of Hematology and Oncology, Jersey Shore University Medical Center, Neptune, NJ, USA.

Abstract

Myeloid sarcoma (MS) is a very rare malignant tumour composed of myeloblasts. It most commonly involves soft tissue, bone, periosteum and lymph nodes, but unusual presentation sites have also been reported. Typically, MS evolves concurrently with active leukaemia or following remission, when it is known as secondary MS. But rarely MS can occur de novo without evidence of concomitant haematological disease. Herein, we report an unusual case of central nervous system-MS in a patient without evidence of concomitant haematological disease. In this case, progressive thoracic and lumbar pain with paraplegia ultimately led to the diagnosis of acute myeloid leukaemia. We also conducted a PubMed search for case reports, case series and reviews of past literature regarding central nervous system-MS and report our findings.

Learning points: Myeloid sarcoma (MS) can present de novo in the absence of antecedent leukaemia.Clinical manifestations of neural MS can be variable, including rare ones like spinal cord compression.Timely recognition of MS is paramount, as it is potentially curable.

Keywords: Central nervous system-myeloid sarcoma; acute myeloid leukaemia; chloroma; granulocytic sarcoma.