Affiliations: Department of Neurology, Children's Hospital Boston,
Boston, MA, USA | Division of Hematology and Oncology, Children's
Hospital Boston, Boston, MA, USA | Department of Pathology, Children's Hospital Boston,
Boston, MA, USA
Note: [] Correspondence: Dr. Nicole J. Ullrich, M.D., Department of
Neurology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02446,
USA. Tel.: +1 617 355 3193; Fax: +1 617 730 0282; E-mail:
nicole.ullrich@childrens.harvard.edu
Abstract: Back pain is often reported in children undergoing cancer treatment,
but is not typically a presenting symptom. Spinal cord compression secondary to
myeloid sarcoma (chloroma) has been described, although is rare in children. We
describe a 10-year-old child who presented with thoracic back pain, which
progressed quickly to complete paraplegia prior to the diagnosis of myeloid
leukemia. Neuroimaging demonstrated an extradural mass at level T6 to T10,
requiring emergent laminectomy and posterior decompression. Histopathology of
this lesion was consistent with myeloid sarcoma while peripheral blood and bone
marrow examination documented acute myeloid leukemia. He underwent treatment
with multiagent chemotherapy and remains in remission. Increased recognition of
ominous symptoms that suggest underlying pathology or signs of cord compression
will lead to earlier diagnosis and, ultimately, minimize neurologic
morbidity.
