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Table · dataset · 2026

Video 1_Spinal granulocytic sarcoma with both extradural and intradural involvement: a case report.mp4

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Introduction<p>Granulocytic sarcoma (GS) is a rare extramedullary accumulation of myeloid blasts.

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Cases of GS with isolated intradural presentation sparing the underlying bone are extremely rare.</p>Case description<p>A 75-year-old male patient with a remote history of acute myeloid leukemia (AML) in 30-year remission presented with progressive lumbar radiculopathy. Magnetic Resonance Imaging (MRI) revealed intradural lesions spanning L2–S1, mimicking nerve sheath tumors.

The patient underwent emergency laminectomy and resection of a vascular, grayish-green L2 mass adherent to the cauda equina. Immunohistochemistry confirmed it was a GS (MPO+, CD43+, CD68+) with no evidence of bone marrow relapse. Following surgery and consolidation chemotherapy, the patient’s neurological status improved (ASIA C to D).

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However, he developed disseminated CNS relapse four months later and succumbed to disease progression 7 months postoperatively.</p>Conclusion<p>Isolated intradural GS constitutes a rare manifestation of extramedullary AML relapse and frequently masquerades radiologically as common benign nerve sheath tumors. While urgent surgical decompression facilitates significant neurological recovery, long-term survival is strictly dictated by the efficacy of systemic disease control.

Therefore, adopting a multidisciplinary strategy integrating intraoperative frozen-section analysis, rigorous immunohistochemical profiling, and early adjuvant chemotherapy is paramount for avoiding diagnostic delays and optimizing patient outcomes.</p>

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Disease 75% · Imaging 75% · Magnetic resonance imaging 75% · Video 75%
Provenance · 1 source records, 20 field assertions
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