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We report a rare case of myeloid sarcoma of the central nervous system (CNS) causing neuropsychiatric symptoms in an elderly woman with a history of JAK2-positive polycythemia vera and acute myeloid leukemia (AML) in long-term remission. The patient presented with a one-month history of complex visual hallucinations, short-term memory loss, and personality changes. Magnetic resonance imaging revealed a 2.4-cm enhancing mass in the septum pellucidum extending between the frontal horns of the lateral ventricle. Cytological analysis of the cerebrospinal fluid showed pleocytosis, and flow cytometry identified a 50% population of CD34\u2009+\u2009blasts, consistent with the immunophenotype of the patient\u2019s prior biopsy-proven AML. This case highlights an exceedingly unusual presentation of AML relapse and emphasizes the need for clinicians to consider CNS involvement in hematologic patients presenting with new-onset neuropsychiatric symptoms, regardless of remission status.<\/jats:p>","DOI":"10.1007\/s00277-026-07127-5","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:44:37Z","timestamp":1781196277000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Myeloid sarcoma of the septum pellucidum causing hallucinations and personality changes in an elderly woman: a case report"],"prefix":"10.1007","volume":"105","author":[{"given":"Rodrigo","family":"Garcia-Santisteban","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kaufman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Vinay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hac-Tu Jacqueline","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren","family":"Brenner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad","family":"Voin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"issue":"10","key":"7127_CR1","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.3390\/brainsci13101443","volume":"13","author":"C De Abbatantuono","year":"2023","unstructured":"Abbatantuono C, Alfeo F, Clemente L, Lancioni G, De Caro MF, Livrea P, Taurisano P (2023) Current challenges in the diagnosis of progressive neurocognitive disorders: a critical review of the literature and recommendations for primary and secondary Care. 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