Isolated Extramedullary Relapse of Acute Lymphoblastic Leukemia Presenting as an Paraspinal Mass.
- Author:
Ji Young KIM
1
;
Hee Ra KIM
;
Chan Ook WOO
;
Jung Hwa LEE
;
Un Yong CHUNG
;
Kwang Chul LEE
Author Information
1. Department of Pediatrics, Korea University, College of Medicine, Seoul, Korea. yh951637@chol.com
- Publication Type:Case Report
- Keywords:
Acute lymphoblastic leukemia;
Extramedullary relapse;
Paraspinal mass
- MeSH:
Adolescent;
Bone Marrow;
Bone Marrow Transplantation;
Child;
Drug Therapy;
Extremities;
Humans;
Male;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*;
Recurrence*;
Spinal Cord
- From:Korean Journal of Pediatric Hematology-Oncology
2004;11(1):68-73
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Despite improvements in therapy, cases in which relapse occurs are still common in children with acute lymphoblastic leukemia (ALL). Most relapses occur in the bone marrow, and extramedullary relapse is most commonly in the central nerve system. Soft tissue mass lesion or spinal cord involvement is extremely unusual in ALL relapse. We experienced a 13-year-old boy who presented with extremity weakness and pain. He was diagnosed with ALL 4 years ago and achieved complete remission after systemic chemotherapy. Imaging study revealed a paraspinal mass which was invading the S1-2 vertebral body. Histopathologic examination revealed infiltrates composed of immature lymphoblasts with morphology identical with that of initially diagnosed bone marrow aspiration. Studies on bone marrow were negative for disease at this time. He was treated with irradiation and intrathecal chemotherapy, in addition to systemic chemotherapy. The mass has nearly disappeared, and he is planned for allogeneic bone marrow transplantation.
