TUMOR OF THE SPINAL CANAL ¨C A RARE LOCALISATION OF
THE ACUTE MYELOBLASTIC LEUKEMIA (AML) IN CHILDREN - A CASE REPORT
Peregud-Pogorzelski J, Brodkiewicz A, Woźniak S, Fydryk J
Ist
Department of Paediatrics1, Pomeranian Medical University, Poland
Presentation symptoms produced by the spinal cord compressed by
tumor mass are seldom described features of AML A case of 10-year-old girl,
born of the Ist pregnancy and Ist delivery, is
described. No previous family history of malignancy. The child was admitted
because of paleness, fatigue, apathy and increasing pain in lower
extremities and spinal column for 3-4 weeks. During one day of
hospitalisation the general status of the child rapidly worsened. The girl
presented with flaccid paresis of the lower extremities and dysfunction of
rectal sphincter. Neurological examination proved total loss of superficial
and deep sensibility. Spinal MRI revealed the presence of tumor within the
spinal canal which compressed the spinal cord at Th8-Th10. Prompt
neurosurgical procedure allowed total excision of epidural tumor mass
(15/10 mm). Laboratory findings revealed anaemia, thrombocytopenia and
normal white blood cell count (45% of blasts). Bone marrow aspiration
biopsy revealed 75% of blasts. Chest x-ray, abdominal ultrasonography and
lumbar puncture were normal. Basing on morphology of malignant cells in
bone marrow and immunophenotyping using flow cytometry the diagnosis of
type M2 AML was established. The treatment consisted of BFM ANLL 98
protocol and kinesiotherapy. The neurological symptoms gradually subsided
and haematological parameters and general condition of the child improved.
At present the girl is in remission of the basic disease. She regained ca
85-90% of her initial (before diagnosis of AML) physical fitness. The
authors would like to underline extremely rare, atypical manifestation of
AML at diagnosis, severe clinical symptoms in CNS and need for aggravating
neurosurgical procedure.