Primary isolated lumbar spine myeloid sarcoma: a rare case report and review of the literature.

Myeloid sarcoma is a rare extramedullary malignancy of immature myeloid cells that is most commonly associated with acute myeloid leukemia, while primary isolated spinal involvement without systemic disease is exceedingly uncommon and diagnostically challenging. We report a rare case of isolated lumbar myeloid sarcoma in a 39-year-old non-leukemic man who presented with an eight-month history of low back pain and radiculopathy, normal neurological and laboratory findings, and imaging suggestive of a benign nerve sheath tumor. Surgical decompression and resection were performed, and histopathological and immunohistochemical analysis confirmed myeloid sarcoma. A systematic literature review identified 14 similar cases, most frequently involving the lumbosacral spine, in which combined surgical and systemic therapy was associated with favorable neurological and oncological outcomes. In our case, the patient achieved radiological regression following AML-based chemotherapy and stem cell transplantation, with no evidence of systemic disease at one-year follow-up, highlighting the importance of early surgical intervention, accurate tissue diagnosis, and multidisciplinary management in optimizing outcomes for isolated spinal myeloid sarcoma.