Spinal cord involvement in leukemia: a review of the literature and a case of Ph1+ acute myeloid leukemia presenting with a conus medullaris syndrome.

A 21-year-old male with Ph1 positive acute myeloid leukemia (AML) became constipated, experienced pain in the sacral area and retained urine. These were the principle presenting complaints of his disease. With local radiotherapy and systemic chemotherapy, all neurologic symptoms and signs disappeared within three days. A conus medullaris syndrome is uncommon in leukemia, as we were able to find only three other such patients in the literature and three others with the closely related cauda equina syndrome. A literature review of spinal cord involvement in leukemia in general revealed 67 reasonably well-described cases. Compilation of data from these suggests it is most often seen in patients with AML and that it is most common in the second decade of life. Tumors extrinsic to but compressing the cord are the most common finding and the thoracic cord is the most common site of involvement.