A clinical report of intracranial granulocytic sarcoma and a literature review

Abstract

Background

Granulocytic sarcoma (GS), is also referred to as myeloid sarcoma. It is a solid mass formed by the primitive or immature myeloid cells extramedullary infiltration, which is commonly caused by acute myelogenous leukemia (AML) or chronic myelogenous leukemia (CML). It mainly involves bones, lymph nodes, skin and soft tissues of the head and neck. In general, the incidence is low and central nervous system (CNS) involvement is relatively rare. The clinical manifestations of the disease are varied and the treatment is intractable.

Case Description

A 53-year-old male with intracranial granulocytic sarcoma who suffered a pressing pain on the left cheek. The patient had a hypophasis with left corneal reflex diminished. He had bilateral anisocoria, lower jaw and tongue tilted to the left upon opening the mouth and the left pharyngeal reflex was declined. The whole blood routine was normal except for eosinophils, head magnetic resonance imaging plain scan revealed a space-occupying lesion. Postoperative pathology suggested GS. Unfortunately, the disease progressed quickly and the patient died.

Conclusion

Isolated GS is often difficult to diagnose accurately. The patient’s medical history should be carefully reviewed, all relevant tests should be performed, and various differential diagnoses should be familiarized with to improve the accuracy of diagnosis. And on this basis, to develop a personalized treatment plan for different patients.

Keywords:

• Granulocytic sarcoma
• intracranial
• leukemia
• immunohistochemistry
• diagnosis
• treatment

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contribution

Hao Cheng came up with the idea and wrote the manuscript. Chenhui Zhao, Guangfu Di and Professor Xiaochun Jiang performed the surgery and management of the peri-operation. Professor Xiaochun Jiang reviewed the manuscript.

Additional information

Funding

The present research was supported by grants from Nature Science Research Project of Anhui province (1908085QH356).