BMJ Case Reports 2017; doi:10.1136/bcr-2017-219936
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Persistent sacral chloroma in refractory acute myelogenous leukaemia

  1. Dennis John Kuo
  1. Pediatric Hematology-Oncology, University of California, San Diego, California, USA
  1. Correspondence to Dr Dennis John Kuo, dekuo{at}
  • Accepted 12 June 2017
  • Published 6 July 2017


Acute myelogenous leukaemia (AML) is a clonal process involving the myeloid subgroup of white blood cells. Chloromas, or myeloid sarcomas, are masses of myeloid leukaemic cells and are a unique aspect of AML. This case involves a 14-year-old boy with AML who presented with multiple chloromas at diagnosis. The patient’s extra-calvarial masses and bone marrow involvement responded to chemotherapy; however, his sacral epidural chloromas persisted despite four courses of chemotherapy. The central nervous system, bone marrow and testes have been known to be sanctuary sites for AML. This case illustrates that the sacral spinal canal may potentially be a sanctuary site for the disease process also.


  • Contributors SM and DK both contributed to the conception, design, writing and editing of the manuscript. SM and DK also both directly cared for the patient.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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