Meng Chen, Moqin Jiang, Weifeng Zhang, Lei Zhao, Ying Zhang
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引用次数: 0
Abstract
Background: Atraumatic splenic rupture (ASR) is rare and typically attributed to underlying pathological conditions, with neoplastic diseases being the main etiologies. Traditionally, surgical intervention has been the standard approach for managing ASR in the majority of patients. However, reports on the outcomes of conservative management, especially for ASR related to myeloid neoplasms, are scarce.
Case description: Here, we present two case reports involving ASR associated with myeloid neoplasms. The first patient, suffering from chronic myelomonocytic leukemia (CMML) harboring CBL and ASXL1 mutations, developed ASR shortly after receiving treatment with the hypomethylating agent 5-azacytidine. The second patient, in the blast phase of myeloproliferative neoplasms (MPN), experienced ASR during the progression of their disease. In the initial case, despite experiencing intense abdominal pain and hypovolemic shock, the patient responded favorably to prompt fluid resuscitation and blood transfusion upon, thanks to a timely diagnosis. A non-operative management approach successfully averted the need for splenectomy or arterial embolism, leading to a favorable outcome. In the second case, the patient presented with progressive abdominal pain but remained hemodynamic stability throughout the ASR episode. We opted for a cautious approach, prioritizing resuscitation, close monitoring, and a watchful waiting strategy. Regrettably, the patient's condition deteriorated, marked by increasing splenomegaly, unchecked leukocytosis, and recurrent parenchymal hemorrhages.
Conclusions: Here, we report two cases of ASR in myeloid neoplasms, demonstrating that patients may achieve acceptable outcomes with conservative management.
期刊介绍:
The Chinese Clinical Oncology (Print ISSN 2304-3865; Online ISSN 2304-3873; Chin Clin Oncol; CCO) publishes articles that describe new findings in the field of oncology, and provides current and practical information on diagnosis, prevention and clinical investigations of cancer. Specific areas of interest include, but are not limited to: multimodality therapy, biomarkers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to cancer. The aim of the Journal is to provide a forum for the dissemination of original research articles as well as review articles in all areas related to cancer. It is an international, peer-reviewed journal with a focus on cutting-edge findings in this rapidly changing field. To that end, Chin Clin Oncol is dedicated to translating the latest research developments into best multimodality practice. The journal features a distinguished editorial board, which brings together a team of highly experienced specialists in cancer treatment and research. The diverse experience of the board members allows our editorial panel to lend their expertise to a broad spectrum of cancer subjects.