Granulocytic sarcoma presenting as cauda equina syndrome

Granulocytic sarcoma (GS) is a tumour formed by myeloid precursors in an extramedullary site and is associated with myeloid leukaemias and other myeloproliferative disorders. We present a patient with symptoms of cauda equina compression where MRI of the spine showed extradural lesions at S1 and L3 levels. This patient had normal bone marrow and peripheral brood for a further 6 weeks from onset of symptoms. Such aleukaemic presentations of GS are rare and have potential for misdiagnosis and delay in treatment. Therefore we recommend early open biopsy of such tumours. (C) 1998 Elsevier Science B.V. All rights reserved.