Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is Enough
Spinal cord compression (SCC) is a rare initial presentation and complication of acute lymphoblastic leukemia (ALL) with nearly all reported cases occurring in the pediatric population. We report a 38-year-old previously healthy man who presented with acute on chronic lower back pain, gait instabili...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2020/8735724 |
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| author | Albert Jang Kallie N. Kram Scott N. Berger Mahmoud R. Gaballa Lee B. Lu David R. Dunaway Courtney N. Miller-Chism |
| author_facet | Albert Jang Kallie N. Kram Scott N. Berger Mahmoud R. Gaballa Lee B. Lu David R. Dunaway Courtney N. Miller-Chism |
| author_sort | Albert Jang |
| collection | DOAJ |
| description | Spinal cord compression (SCC) is a rare initial presentation and complication of acute lymphoblastic leukemia (ALL) with nearly all reported cases occurring in the pediatric population. We report a 38-year-old previously healthy man who presented with acute on chronic lower back pain, gait instability, urinary retention, and severe thrombocytopenia. Radiologic examination revealed two soft tissue masses of the thoracic spine associated with compression fractures causing spinal canal narrowing and cord compression. Bone marrow biopsy confirmed the diagnosis of ALL. Immediate initiation of high-dose corticosteroids and systemic chemotherapy resolved the patient’s symptoms without radiation therapy or surgical intervention. After two courses of chemotherapy, the patient achieved complete remission in the bone marrow. Rapid administration of chemotherapy alone in this case resulted in a complete resolution of SCC. Given the rarity of this complication in adults, no standardized treatment has been established. The success of this case recommends chemotherapy as the initial management of SCC in chemotherapy-naïve ALL. |
| format | Article |
| id | doaj-art-f83d996704394b6a9fafa4f45d45d6fb |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-f83d996704394b6a9fafa4f45d45d6fb2025-02-03T01:25:17ZengWileyCase Reports in Medicine1687-96271687-96352020-01-01202010.1155/2020/87357248735724Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is EnoughAlbert Jang0Kallie N. Kram1Scott N. Berger2Mahmoud R. Gaballa3Lee B. Lu4David R. Dunaway5Courtney N. Miller-Chism6School of Medicine, Baylor College of Medicine, Houston, TX, USASchool of Medicine, Baylor College of Medicine, Houston, TX, USASchool of Medicine, Baylor College of Medicine, Houston, TX, USASection of Hematology-Oncology, Department of Medicine, Baylor College of Medicine, Houston, TX, USADepartment of Medicine, Baylor College of Medicine, Houston, TX, USADepartment of Radiology, Baylor College of Medicine, Houston, TX, USASection of Hematology-Oncology, Department of Medicine, Baylor College of Medicine, Houston, TX, USASpinal cord compression (SCC) is a rare initial presentation and complication of acute lymphoblastic leukemia (ALL) with nearly all reported cases occurring in the pediatric population. We report a 38-year-old previously healthy man who presented with acute on chronic lower back pain, gait instability, urinary retention, and severe thrombocytopenia. Radiologic examination revealed two soft tissue masses of the thoracic spine associated with compression fractures causing spinal canal narrowing and cord compression. Bone marrow biopsy confirmed the diagnosis of ALL. Immediate initiation of high-dose corticosteroids and systemic chemotherapy resolved the patient’s symptoms without radiation therapy or surgical intervention. After two courses of chemotherapy, the patient achieved complete remission in the bone marrow. Rapid administration of chemotherapy alone in this case resulted in a complete resolution of SCC. Given the rarity of this complication in adults, no standardized treatment has been established. The success of this case recommends chemotherapy as the initial management of SCC in chemotherapy-naïve ALL.http://dx.doi.org/10.1155/2020/8735724 |
| spellingShingle | Albert Jang Kallie N. Kram Scott N. Berger Mahmoud R. Gaballa Lee B. Lu David R. Dunaway Courtney N. Miller-Chism Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is Enough Case Reports in Medicine |
| title | Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is Enough |
| title_full | Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is Enough |
| title_fullStr | Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is Enough |
| title_full_unstemmed | Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is Enough |
| title_short | Acute Lymphoblastic Leukemia Presenting Initially as Spinal Cord Compression: When Chemotherapy Alone Is Enough |
| title_sort | acute lymphoblastic leukemia presenting initially as spinal cord compression when chemotherapy alone is enough |
| url | http://dx.doi.org/10.1155/2020/8735724 |
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