Intracerebral Granulocytic Sarcoma in recurrence of Chronic Myeloid Leukemia.

A 21-year-old male with a 2-year diagnosis of chronic myeloid leukemia in complete hematologic and cytogenetic responses was admitted to hospital with drowsiness, headache and seizures. Laboratory evaluation disclosed leucocitosis with 19.0% of peripheral blasts. Brain magnetic resonance imaging (MRI) (Figure 1) corroborated the diagnosis of granulocytic sarcoma (GS) in blast crisis. MRI performed 38 days after chemotherapy was indicative of tumor regression (Figure 2). GS is an extramedullary solid tumor composed of immature myeloid cells. It develops before, during or after the onset of myeloid leukemia. Intra-axial GS without involvement of skull or meninges is rare.