Xu Qingsheng, Wang Ming, You Qihan, Wang Huafeng, Ye Ke, Zhan Renya, Zhou Yongqing
Department of Neurosurgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zheijaiang Province, P.R.C.
Neurol Med Chir (Tokyo). 2009 Dec;49(12):611-5. doi: 10.2176/nmc.49.611.
Two patients presented with rare isolated recurrence of granulocytic sarcoma. A 29-year-old male presented with an extra- and intracranial mass 10 years after bone marrow transplantation for chronic myeloid leukemia. A 34-year-old female presented with an intracranial mass 3 years after complete remission of acute myeloid leukemia-M2a. Both patients underwent surgical resection. The first patient received adequate postoperative radiotherapy and chemotherapy, and achieved complete remission without evidence of diseases during the 6-month follow up. The second patient only received whole brain radiotherapy, failed to respond, and died of systemic leukemia later. These two cases demonstrate that neurosurgeons should pay attention to the occurrence of isolated recurrent granulocytic sarcoma, especially in patients with a history of hematologic neoplasm. Immediate pathological and cytogenetic diagnoses are essential.
两名患者出现了罕见的孤立性粒细胞肉瘤复发。一名29岁男性在接受慢性髓性白血病骨髓移植10年后出现颅外和颅内肿块。一名34岁女性在急性髓性白血病-M2a完全缓解3年后出现颅内肿块。两名患者均接受了手术切除。第一名患者术后接受了充分的放疗和化疗,在6个月的随访期间实现了完全缓解,无疾病证据。第二名患者仅接受了全脑放疗,无反应,后来死于全身性白血病。这两例病例表明,神经外科医生应注意孤立性复发性粒细胞肉瘤的发生,尤其是有血液系统肿瘤病史的患者。立即进行病理和细胞遗传学诊断至关重要。