Abstract
Spontaneous rupture of the spleen (SRS) is a rare clinical entity with a potentially poor medical outcome. In most cases, SRS is caused by neoplastic disorder. Acute promyelocytic leukaemia is a rare but important cause of SRS that physicians are required to assess for. We present a 28-year-old woman with APL and COVID-19 pneumonia, who successfully underwent embolisation of the splenic artery for spontaneously occurring splenic rupture during induction chemotherapy. After the intervention the patient completed induction chemotherapy and achieved complete remission. Our case demonstrates that emergent transcatheter arterial embolisation can be lifesaving even in the unfavourable condition of a patient with severe immune deficiency.
Highlights
Spontaneous rupture of the spleen (SRS) is a rare clinical entity with a potentially poor medical outcome
We present a 28-year-old woman with Acute promyelocytic leukaemia (APL) and COVID-19 pneumonia, who successfully underwent embolisation of the splenic artery for spontaneously occurring splenic rupture during induction chemotherapy
Acute promyelocytic leukaemia (APL) is a unique subtype of acute myeloid leukaemia (AML), cytogenetically characterized by a balanced reciprocal translocation between chromosomes 15 and 17, which results in the fusion of the promyelocytic leukaemia (PML) and retinoic acid receptor alpha (RARα) genes [2]
Summary
Spontaneous rupture of the spleen (SRS) is a rare clinical entity with a potentially poor medical outcome. It may be caused by neoplastic, infectious and inflammatory diseases and mechanical disorders or may be drug and treatment related. SRS is an extremely rare complication in APL. Only 3 cases of APL with SRS treated with splenectomy have been reported in literature [3] [4] [5]. We present the first case of APL and SRS successfully treated by transcatheter arterial embolisation (TAE) of the splenic artery and give an overview of similar cases reported in literature
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