Oliveira Edson, Lavrador José Pedro, Teixeira Joaquim, Pignatelli Alexandra, Livraghi Sérgio
Department of Neurosurgery, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
Department of Pathology, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
Surg Neurol Int. 2016 Nov 21;7(Suppl 38):S908-S910. doi: 10.4103/2152-7806.194517. eCollection 2016.
Myeloid sarcoma (MS) is a malignant tumor that usually occurs concomitantly with or following acute myeloid leukemia (AML). Cavernomas are benign congenital malformations that are unusual in the spine and exceedingly rare in pure extradural locations.
We report a 73-year-old female with a previous medical history of AML in remission for 3 years who presented with symptoms of low back pain and right lower extremity radiculopathy. A magnetic resonance scan showed an extradural, foraminal lesion centered at the L2 level involving the right L2 nerve root. In view of the history of AML, this lesion was potentially considered MS, a form of AML relapse. Surgery consisting of a right L1 and L2 hemilaminectomy facilitated gross total resection of the purely extradural lesion the proved histologically to be a cavernoma.
In patients with a history of leukemia, MS must be considered in the differential diagnosis for any epidural or nerve root lesion that appears following treatment. Although rare, cavernomas must be considered among the differential diagnoses for epidural nerve root lesions in the setting of AML.
髓系肉瘤（MS）是一种恶性肿瘤，通常与急性髓系白血病（AML）同时发生或在其之后出现。海绵状血管瘤是一种良性先天性畸形，在脊柱中较为少见，在单纯硬膜外部位极为罕见。
我们报告一名73岁女性，既往有AML病史，已缓解3年，出现腰痛和右下肢神经根病症状。磁共振扫描显示一个硬膜外、椎间孔病变，位于L2水平，累及右侧L2神经根。鉴于AML病史，该病变可能被认为是MS，一种AML复发形式。手术包括右侧L1和L2半椎板切除术，有助于对纯粹硬膜外病变进行大体全切，术后病理证实为海绵状血管瘤。
对于有白血病病史的患者，在鉴别诊断治疗后出现的任何硬膜外或神经根病变时，必须考虑MS。尽管罕见，但在AML背景下，硬膜外神经根病变的鉴别诊断中必须考虑海绵状血管瘤。
