Author:
Schoolmeesters I.,Kempeneers K.,Sciot B.,Huybrechts X.
Abstract
Lumbago as a symptom of an extramedullary tumour in acute myeloid leukaemia
A 58-year-old man with acute myeloid leukaemia presents with low back pain. Because of his oncologic history and severe pain during the night, additional radiographic imaging was performed. These alarm signals or so-called red flags are described in the guidelines of the Belgian Health Care Knowledge Centre (KCE). Imaging showed a mass at the 10th thoracic vertebra, suspected to be an extramedullary tumour consisting of myeloblasts, originating from the previously diagnosed acute myeloid leukaemia. A biopsy confirmed this diagnosis.
Since these tumours present with different symptoms and at different locations, every physician should be aware of them. They are treated systemically with chemotherapy, like the intramedullary disease, sometimes supplemented with local therapy. In some cases, this disease manifestation presents prior to or without the diagnosis of acute myeloid leukaemia. A correct histological diagnosis is then essential for a correct treatment.