[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-432915-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-432915-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","extramedullary-relapse-of-acute-myeloid-leukemia-presenting-as-an-epidural-spinal-mass-with-vertebral-and-acetabular-leukemic-involvement-a-case-report","Extramedullary relapse of acute myeloid leukemia presenting as an epidural spinal mass with vertebral and acetabular leukemic involvement - A case report","","Extramedullary relapse of acute myeloid leukemia (AML) denotes leukemic infiltration into tissues outside bone marrow and is uncommon, especially involving the central nervous system after allogeneic stem cell transplantation. This report describes a 28-year-old male two years post-transplant who developed progressive lower-extremity weakness and paresthesia. Imaging showed a thoracic epidural mass causing spinal cord compression with FDG-avid involvement of multiple vertebrae and the left acetabulum. Surgical decompression and biopsy confirmed leukemic infiltration.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/extramedullary-relapse-of-acute-myeloid-leukemia-presenting-as-an-epidural-spinal-mass-with-vertebral-and-acetabular-leukemic-involvement-a-case-report/432915/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/extramedullary-relapse-of-acute-myeloid-leukemia-presenting-as-an-epidural-spinal-mass-with-vertebral-and-acetabular-leukemic-involvement-a-case-report/432915.png","ImageObject",300,407,{"name":42,"@type":43},"Blue Pony","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What does extramedullary relapse of AML mean in this case?","Question",{"text":63,"@type":64},"It refers to leukemic cells infiltrating tissues outside the bone marrow. Here, the relapse manifested as a thoracic epidural spinal mass plus involvement of multiple vertebrae and the left acetabulum.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What symptoms led to the patient’s evaluation?",{"text":68,"@type":64},"The patient developed progressive weakness in the lower extremities and paresthesia, raising concern for spinal cord compression.",{"name":70,"@type":61,"acceptedAnswer":71},"How was the diagnosis confirmed?",{"text":72,"@type":64},"Surgical decompression and biopsy of the spinal epidural mass confirmed leukemic infiltration.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},432915,1790718374,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":123,"preview_page_count":4},962090760266,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Radiology Ca s e Reports 21 (2026) 1092 – 1095  \nAvailable online [at](at www.sciencedirect.com)[ www.sciencedirect.com](at www.sciencedirect.com)  \njournal [homepage:](homepage: www.elsevier.com/locate/radcr)[ www.elsevier.com/locate/radcr](homepage: www.elsevier.com/locate/radcr)  \n| Case Report\u003Cbr>Extramedullary relapse of acute myeloid leukemia presenting as an epidural spinal mass with vertebral and acetabular leukemic involvement:\u003Cbr>A case report ✩\u003Cbr>Biraj Bista, MDa, Sworup Thapa, BSb,∗\u003Cbr>a Department of Radiological Sciences, City of Hope Cancer Research Hospital, 1500 E Duarte Rd. Duarte, CA 91010, USA\u003Cbr>b The University of Oklahoma College of Medicine, University of Oklahoma Health Sciences Center, 940 Stanton L Young Blvd \\#357, Oklahoma City, OK 73104, USA |  |  |\n| --- | --- | --- |\n| a r t i c l e i n f o |  | a b s t r a c t |\n| Article history:\u003Cbr>Received 16 June 2025 Revised 16 November 2025 Accepted 17 November 2025 |  | Extramedullary relapse of acute myeloid leukemia (AML) refers to the infiltration of leukemic cells into tissues outside the bone marrow and is a rare occurrence involving central nervous system, particularly following allogeneic stem cell transplantation. We report a rare case of extramedullary relapse of acute myeloid leukemia (AML) presenting asa thoracic epidural mass with additional multiple vertebrae and acetabular leukemic involvement in a 28-year-old male, two years postallogeneic stem cell transplantation. The patient presented with progressive lower extremity weakness and paresthesia. Imaging revealed an extensive epidural mass causing spinal cord compression, along with increased 18F-fluorodeoxyglucose uptake in the mass, multiple vertebrae and the left acetabulum. Surgical decompression and biopsy of the spinal epidural mass confirmed leukemic infiltration. To our knowledge, this is the first reported case of extramedullary AML relapses simultaneously involving the epidural space, multiple vertebrae and acetabulum.\u003Cbr>© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington.\u003Cbr>This is an open access article under the CC BY-NC-ND license\u003Cbr>([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)) |\n| Key Words:\u003Cbr>Acute myeloid leukemia Extramedullary infiltration Vertebral neoplasms Spinal cord compression Myeloid Sarcoma |  |  |\n\nIntroduction  \nAcute myeloid leukemia (AML) is a hematologic malignancy characterized by the clonal proliferation of abnormal myeloid precursor cells in the bone marrow and peripheral blood that  \nfail to differentiate properly. Consequently, there is a reduction in the production of normal blood cells, leading to symptoms related to bone marrow failure such as anemia, infection, and bleeding [1] .  \nAML predominantly affects adults, with the median age at diagnosis to be 68 years [2] . Extramedullary involvement,  \n✩ Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.  \n∗ Corresponding author.  \nE-mail address: [sworup-thapa@ouhsc.edu](sworup-thapa@ouhsc.edu) (S. Thapa).  \n[https://doi.org/10.1016/j.radcr.2025.11.048](https://doi.org/10.1016/j.radcr.2025.11.048)  \n1930-0433/© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/))  \nFig. 1 –(A) Sagittal precontract T1 and (B) sagittal post contrast T1 weighted MRI showing heterogeneously enhancing diffuse posterior epidural space mass (block arrows) extending from T3 to upper lumbar spine causing effacement of the anterior and posterior thecal sac and mild diffuse spinal cord compression.  \nalso known as extramedullary disease (EMD) or myeloid sarcoma (MS), is a recognized phenomenon inAML, char","cbCaibYY6NQPbLbQ","https://ap.wps.com/l/cbCaibYY6NQPbLbQ","pdf",991336,"English","# Introduction\n# Case\n## Imaging and findings","[{\"question\":\"What does extramedullary relapse of AML mean in this case?\",\"answer\":\"It refers to leukemic cells infiltrating tissues outside the bone marrow. Here, the relapse manifested as a thoracic epidural spinal mass plus involvement of multiple vertebrae and the left acetabulum.\"},{\"question\":\"What symptoms led to the patient’s evaluation?\",\"answer\":\"The patient developed progressive weakness in the lower extremities and paresthesia, raising concern for spinal cord compression.\"},{\"question\":\"How was the diagnosis confirmed?\",\"answer\":\"Surgical decompression and biopsy of the spinal epidural mass confirmed leukemic infiltration.\"}]","Extramedullary relapse of acute myeloid leukemia presenting as an epidural spinal mass with vertebral and acetabular leukemic involvement - A case report | PDF",1790661896]