Pelvic Hematoma Revealing Chronic Myeloid Leukemia: Case Report of Two Patients.

Abstract

Background: Chronic myeloid leukemia [CML] is a common hematological malignancy where patients present with varied clinical symptoms and are usually diagnosed with incidentally detected elevated total leucocyte counts in hemogram. The presence of pelvic hematoma at the presentation of CML is an uncommon finding.

Case presentation: Two male young adults presented with massive splenomegaly and pelvic hematoma. On evaluation for anemia and leukocytosis with massive splenomegaly, diagnosis of CML chronic phase [CML-CP] was made on peripheral smear, bone marrow examination including cytogenetic study and molecular methods [peripheral blood quantitative BCR: ABL1 by real-- time PCR]. The first patient underwent aspiration of hematoma, and the second patient presented late where the hematoma organized into a solid mass and no intervention could be possible. A basic available coagulation study revealed no abnormalities and was managed with tyrosine kinase inhibitors.

Conclusion: Initial manifestation of CML with pelvic hematoma is uncommon and should undergo aspiration or drainage to avoid organization of hematoma and compressive symptoms locally.