Introduction
Chronic myelogenous leukemia is a myeloproliferative disorder
characterized by uncontrolled production of granulocytes, mainly
neutrophils, and myeloid expansion of the bone marrow. There are three
phases of chronic myelogenous leukemia, the chronic phase, accelerated
phase, and blast crises phase. Although it can directly evolve from the
chronic phase to the blast phase, Usually, the disease progresses from
the chronic phase to the blast crises phase.
The clinical manifestation of CML is variable depending on the stage of
the disease at diagnosis.20-50 % of patients are asymptotic at the time
of diagnosis and 85 % of patients are diagnosed in the chronic phase(1,
2).
Systemic symptoms such as fatigue (34 %), malaise (3 %), weight loss
(20 %), drenched sweating (15 %), abdominal fullness (15 %), and
bleeding episodes due to platelet dysfunction (21%) are the commonest
manifestations (2). CML can rarely present with soft tissue hematoma
which can be treated with both tyrosine kinase inhibitors and
conservative management(3, 4). The Morel Lavallee lesion is a close
spontaneous soft tissue injury resulting in hematoma collection between
fascial layers. The diagnosis of CML is suspected by the typical
findings on the peripheral blood and bone marrow, then confirmed by the
presence of the Philadelphia chromosome, BCR/ABL1 fusion gene, or the
BCR/ABL1 fusion mRNA by conventional cytogenetics, fluorescent in situ
hybridization (FISH) or reverse transcription polymerase chain reaction
(RT-PCR) respectively.
Hydroxyurea can be used for cytoreduction while awaiting confirmation of
the diagnosis. Tyrosine kinase inhibitors are the backbone of
management. We report a case of Morel Lavallee lesion in the anterior
abdominal wall as an initial presentation of chronic myelogenous
leukemia.