Abstract / Summary
Myeloid sarcoma (MS) is an extramedullary tumor of myeloid blasts that can occur with or without a previously diagnosed hematologic malignancy.Spinal epidural involvement is uncommon but may cause rapidly progressive spinal cord compression that requires urgent neurological intervention.A previously healthy 22-year-old man presented with rapidly worsening weakness in both lower extremities, hypoesthesia below T4, inability to stand or walk, and urinary retention.Magnetic resonance imaging revealed multifocal posterior epidural masses extending from T3 to T12, accompanied by severe spinal cord compression and intramedullary T2-weighted hyperintensity.Progressive myelopathy prompted urgent T3-T12 laminectomy and tumor removal.Histopathological examination confirmed MS, with positive staining for myeloperoxidase and CD117.Subsequent bone marrow examination showed myeloid hyperplasia with 4% blasts; cytogenetic analysis identified t(8;21)(q22;q22).Lower-extremity motor function improved after surgery.The patient later received systemic chemotherapy and died approximately 1 year after diagnosis.Extensive spinal epidural MS may present as an acute neurological emergency even when no hematological malignancy has previously been recognized.In patients with rapidly progressive spinal cord compression, prompt surgical decompression can facilitate neurological recovery and provide tissue for a definitive diagnosis; systemic hematological therapy remains essential to control the underlying disease.