ArticleFrontiers in oncology2026
Spinal granulocytic sarcoma with both extradural and intradural involvement: a case report.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Granulocytic sarcoma (GS) is a rare extramedullary accumulation of myeloid blasts. Cases of GS with isolated intradural presentation sparing the underlying bone are extremely rare. Case description: 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). However, he developed disseminated CNS relapse four months later and succumbed to disease progression 7 months postoperatively. Conclusion: 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.
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