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23 yo man with left buttock pain Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

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Presentation on theme: "23 yo man with left buttock pain Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology."— Presentation transcript:

1 23 yo man with left buttock pain Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology

2 Vignette A 23 year-old man with recurrent acute myeloid leukemia (AML) underwent successful re-induction. Soon thereafter he complained of pain in his left buttock radiating into his left posterior thigh. Neurological examination was unremarkable. Chamberlain, et al

3 Imaging

4 Sacral chloroma in AML Radiographic evaluation demonstrated a left S2 lesion suggestive of a nerve sheath tumor. Open biopsy revealed a chloroma (a.k.a. myeloid sarcoma). Most chloromas are found in patients with recurrent AML & are overwhelmingly intracranial. Infrequently chloromas are paraspinal and present with epidural spinal cord compression. Intraspinal invasion by a chloroma is rare. Systemic evaluation confirmed recurrent AML for which he was successfully treated with re-induction & whole body irradiation followed by an allogeneic transplant. He is currently disease-free and neurologically asymptomatic 1-year post- transplant. Chamberlain, et al

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