Subcutaneous Hematoma as an Unusual Presentation of Chronic Myelogenous Leukemia following Bone Marrow Aspiration: A Case Report and Narrative Review

Mashategan, Pourya; Abolghasemi, Hassan; Emami Meibodi, Mohammad Kazem

doi:10.61882/ijbc.17.3.1

Volume 17, Issue 3 (September-2025 2025) Iranian Journal of Blood and Cancer 2025, 17(3): 1-4 | Back to browse issues page

‎ 10.61882/ijbc.17.3.1

Mendeley

Zotero

RefWorks

Mashategan P, Abolghasemi H, Emami Meibodi M K. Subcutaneous Hematoma as an Unusual Presentation of Chronic Myelogenous Leukemia following Bone Marrow Aspiration: A Case Report and Narrative Review. Iranian Journal of Blood and Cancer 2025; 17 (3) :1-4
URL: http://ijbc.ir/article-1-1763-en.html

Subcutaneous Hematoma as an Unusual Presentation of Chronic Myelogenous Leukemia following Bone Marrow Aspiration: A Case Report and Narrative Review

Pourya Mashategan¹

, Hassan Abolghasemi ^*²

, Mohammad Kazem Emami Meibodi³

1- Department of Pediatrics, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
2- Department of Pediatrics, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. , HassanAbol@Yahoo.com
3- Department of Orthopedics, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Abstract: (517 Views)

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the BCR-ABL1 fusion gene, also known as the Philadelphia chromosome. Bleeding complications are uncommon in the chronic phase of CML due to preserved platelet function. However, rare cases of subcutaneous hematoma have been reported in association with factor XIII deficiency or other coagulopathies. We report the case of a 19-year-old adolescent diagnosed with CML who developed a subcutaneous hematoma after bone marrow aspiration. The patient presented with localized swelling and tenderness at the aspiration site, which was later confirmed as a hematoma on imaging. Laboratory tests revealed a preserved platelet count, but suggested a possible underlying coagulopathy. Further investigation revealed a factor XIII deficiency contributing to the unusual presentation. This case highlights the importance of considering rare bleeding disorders, such as factor XIII deficiency, in patients with CML who present with unusual bleeding manifestations. Early recognition and management of such complications are critical for optimal patient outcomes.

Keywords: Chronic myeloid leukemia, Subcutaneous hematoma, Bleeding complications, Factor XIII deficiency, BCR-ABL fusion gene, Bone marrow aspiration

Full-Text [PDF 434 kb] (404 Downloads)

: Case report | Subject: Pediatric Hematology & Oncology
Received: 2025/07/4 | Accepted: 2025/09/24 | Published: 2025/09/30

References

1. Abdullah IA, Ghada SA, Arwa ZA. Unilateral Subhyaloid Hemorrhage as a Presenting Sign of Chronic Myeloid Leukemia. American Journal of Case Reports. 2022.

2. Shady Adnan A, Shady Adnan A, Shady A-A, Daehong K, Daehong K, Helena H, et al. Characterization of p190-Bcr-Abl chronic myeloid leukemia reveals specific signaling pathways and therapeutic targets. Leukemia. 2020.

3. Zehtabcheh S, Yousefi AM, Salari S, Safa M, Momeny M, Ghaffari SH, et al. Abrogation of histone deacetylases (HDACs) decreases survival of chronic myeloid leukemia cells: New insight into attenuating effects of the PI3K/c‐Myc axis on panobinostat cytotoxicity. Cell Biology International. 2021;45(5):1111-21. [DOI:10.1002/cbin.11557]

4. Htet Lin H, Htet Lin H, Weixiang L, Weixiang L, Joshua W, Joshua W, et al. Classic myeloproliferative neoplasms in Singapore: A population-based study on incidence, trends, and survival from 1968 to 2017. Cancer Epidemiology. 2022.

5. Ashraf A, Ashraf A, Sara S, Sara S, Dina Sameh S, Dina Sameh S, et al. Hematoma or Bleeding As Initial Presentation of Chronic Myeloid Leukemia (CML): Review. Blood. 2022.

6. David KI, Farshid D, Farshid D, Sarah Schellhorn M, Sarah Schellhorn M, Sarah Schellhorn M, et al. Prediction model for mortality after intracranial hemorrhage in patients with leukemia. American Journal of Hematology. 2011.

7. Höglund M, Sandin F, Simonsson B. Epidemiology of chronic myeloid leukaemia: an update. Ann Hematol. 2015;94 Suppl 2:S241-7. [DOI:10.1007/s00277-015-2314-2]

8. Verena SH, Verena SH, Michele B, Michele B, Joerg H, Joerg H, et al. The EUTOS population-based registry: incidence and clinical characteristics of 2904 CML patients in 20 European Countries. Leukemia. 2015.

9. Yiming C, Yiming C, Haijun W, Haijun W, Hagop MK, Hagop MK, et al. Trends in chronic myeloid leukemia incidence and survival in the United States from 1975 to 2009. Leukemia & Lymphoma. 2013.

10. Manoj L, Manoj L, Hans Raj P, Hans Raj P, Gopal Raj P, Gopal Raj P, et al. Spontaneous Soft Tissue Haematomas- A Rare Presentation of Chronic Myeloid Leukemic (CML). Journal of clinical and diagnostic research : JCDR. 2015.

11. Louise K, Louise K, Kate B, Kate B, Gaurav S, Gaurav S, et al. Gastrointestinal bleeding in a chronic myeloid leukaemia patient precipitated by dasatinib-induced platelet dysfunction: Case report. Platelets. 2015.

12. Vaibhav Raj G, Vaibhav Raj G, Akash S, Akash S, Neha Y, Neha Y, et al. Spontaneous scapular region hematoma extending upto anterior chest wall in a patient of chronic myeloid leukaemia: an unusual site presentation. International Surgery Journal. 2022.

13. Rebecca KJ, Rebecca K-J, Tammuella S, Tammuella S, Cindy L, Cindy AL. Identification and Basic Management of Bleeding Disorders in Adults. Journal of the American Board of Family Medicine. 2014.

14. Yanzhi W, Yanzhi W, Lina W, Lina W, Yaming X, Ya-Ming X, et al. Bleeding with negative coagulation screening test as initial presentation of chronic myelogenous leukemia managed by fresh frozen plasma: A case report. Medicine. 2019.

15. Ankur J, Ankur J. A rare case of chronic myeloid leukemia with acquired von Willebrand disease presenting as subdural hematoma. Journal of Cancer Research and Therapeutics. 2015.

16. Farjah HA, Leena A, Ghada E, Aamer A, Fatmah SA. Bleeding Diathesis as the Initial Presentation of Chronic Myeloid Leukemia: A Case Series. Cureus. 2023.

Send email to the article author

Rights and permissions
	This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb