Persistent sacral chloroma in refractory acute myelogenous leukaemia

BMJ Case Rep. 2017 Jul 6:2017:bcr2017219936. doi: 10.1136/bcr-2017-219936.

Abstract

Acute myelogenous leukaemia (AML) is a clonal process involving the myeloid subgroup of white blood cells. Chloromas, or myeloid sarcomas, are masses of myeloid leukaemic cells and are a unique aspect of AML. This case involves a 14-year-old boy with AML who presented with multiple chloromas at diagnosis. The patient's extra-calvarial masses and bone marrow involvement responded to chemotherapy; however, his sacral epidural chloromas persisted despite four courses of chemotherapy. The central nervous system, bone marrow and testes have been known to be sanctuary sites for AML. This case illustrates that the sacral spinal canal may potentially be a sanctuary site for the disease process also.

Keywords: paediatric oncology; spinal cord; urology.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Examination / methods
  • Diffusion Magnetic Resonance Imaging / methods
  • Humans
  • Injections, Spinal
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / drug therapy
  • Male
  • Sacrum / pathology*
  • Sarcoma, Myeloid / diagnostic imaging
  • Sarcoma, Myeloid / etiology
  • Sarcoma, Myeloid / pathology*
  • Spinal Canal / pathology*
  • Spinal Puncture / methods
  • Treatment Outcome