Bilateral Maxillary, Sphenoid Sinuses and Lumbosacral Spinal Cord Extramedullary Relapse of CML Following Allogeneic Stem Cell Transplant
Hosseini، Soudabeh نويسنده Department of Hematology, Allied Medical School, Iran University of Medical Sciences, Tehran, IR Iran Hosseini, Soudabeh , Ansari، Shahla نويسنده , , Vosough، Parvaneh نويسنده Iran University of Medical Sciences, Tehran, Iran , , Bahoush، Gholamreza نويسنده Assistant professor of pediatric hematology-oncology, Oncopathology research center, Ali Asghar childrens hospital, Iran University of medical sciences, Tehran, Iran. Bahoush, Gholamreza , Shamsizadeh، Morteza نويسنده Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran Shamsizadeh, Morteza , Mehrazma، Mitra نويسنده , , Dorgalaleh، Akbar نويسنده Department of Hematology,Tehran University of Medical Sciences , Tehran, Iran Dorgalaleh, Akbar
Isolated extramedullary relapse of chronic myelogenous leukemia (CML) after allogeneic stem cell transplant is rare. There is a case report of a child who developed a granulocytic sarcoma of the maxillary and sphenoid sinuses and lumbosacral spinal cord mass 18 months after allogeneic bone marrow transplant for CML. He was presented with per orbital edema and neurological deficit of lower extremities and a mass lesion was found on spinal cord imaging. No evidence of hematologic relapse was identified at that time by bone marrow histology or cytogenetic. The patient died 1 month later with a picture of pneumonia, left ventricular dysfunction and a cardiopulmonary arrest on a presumed underlying sepsis with infectious etiology. Granulocytic sarcoma should be considered in the differential diagnosis of mass lesions presenting after allogeneic bone marrow transplantation for CML, even if there is no evidence of bone marrow involvement.