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.