Isolated extramedullary myeloid sarcoma causing cauda equina compression in a young male

We report a case of a 22-year-old young male presenting with radicular pain of lower limbs, with urinary retention and erectile dysfunction due to cauda equina compression by a pre-sacral mass, which was shown to be an extramedullary myeloid sarcoma on histopathology and immunohistochemistry. However, the patient did not have any evidence of acute myelogenous leukaemia either in peripheral blood or bone marrow. He responded favourably to treatment by local external beam radiotherapy and systemic chemotherapy using the 3 + 7 protocol. Isolated extramedullary myeloid sarcoma causing cauda equina compression is extremely rare, with very few case reports published earlier. Our case also emphasizes the importance of aggressive combined-modality treatment in such patients to achieve durable remission and preserve reasonable quality of life.