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Review
. 2023 Feb 1;62(3):453-457.
doi: 10.2169/internalmedicine.9580-22. Epub 2022 Jul 5.

Epidural Spinal Cord Compression as the Presenting Manifestation of Acute Myeloid Leukemia: A Case Report and Literature Review

Affiliations
Review

Epidural Spinal Cord Compression as the Presenting Manifestation of Acute Myeloid Leukemia: A Case Report and Literature Review

Tomoko Fujikawa et al. Intern Med. .

Abstract

We herein report a rare case of spinal cord compression due to epidural involvement of acute myeloid leukemia (AML). A 14-year-old boy presented with a 7-day history of back pain, paraplegia and hypoesthesia. Contrast-enhanced computed tomography revealed an epidural mass. Emergency laminectomy and resection of the mass were performed. Histopathologically, the resected mass was comparable to an extramedullary mass of AML. Chemotherapy was initiated, and complete remission was achieved. Neurological sequelae remained after the treatment. Based on the present and previous reports, spinal cord compression from epidural AML involvement may progress rapidly.

Keywords: acute myeloid leukemia; extramedullary infiltration; spinal cord compression.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
a: Contrast-enhanced computed tomography at admission. The sagittal image showed a posterior epidural mass (arrows) at the seventh-ninth thoracic vertebra (T7-9) level. b: Spine magnetic resonance image three months after surgery (b-1). T2-weighted imaging revealed the hyperintensity of the posterior funiculus in the spinal cord higher than T6 (b-2) (arrow) and the lateral funiculus in the spinal cord lower than T10 (b-3) (arrows). c: Histopathological images of the resected mass stained with Hematoxylin and Eosin staining (c-1), CD34 (c-2), myeloperoxidase (c-3), and c-kit (c-4). d: A flow cytometry analysis of the bone marrow aspirate.
Figure 2.
Figure 2.
Distribution of the epidural extramedullary infiltration in the spine.

References

    1. Ohanian M, Faderl S, Ravandi F, et al. Is acute myeloid leukemia a liquid tumor? Int J Cancer 133: 534-543, 2014. - PMC - PubMed
    1. Stove HK, Sandahl JD, Abrahamsson J, et al. Extrameddullary leukemia in children with acute myeloid leukemia: a population-based cohort study from the Nordic Society of Pediatric Hematology and Oncology (NOPHO). Pediatr Blood Cancer 64: e26520, 2017. - PubMed
    1. Johnson DL, Alonzo TA, Gerbing RB, Lange BJ, Woods WG. Superior outcome of pediatric acute myeloid leukemia patients with orbital and CNS myeloid sarcoma: a report from the Children's Oncolgy Group. Pediatr Blood Cancer 58: 519-524, 2012. - PMC - PubMed
    1. Prased D, Schiff D. Malignant spinal-cord compression. Lancet Oncol 6: 15-24, 2005. - PubMed
    1. Gunes D, Uysal KM, Cetinlkaya H, et al. Paravertebral malignant tumors of childhood: analysis of 28 pediatric patients. Childs Nerv Syst 25: 63-69, 2009. - PubMed

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