Subgaleal hematoma as the first presentation of chronic myeloid leukemia: one case report and literature review

Abstract

Objective To deepen the understanding of clinicians for giant subgaleal hematoma complicated with intraorbital hematoma as the first presentation of chronic myeloid leukemia in chronic phase （CML-CP）. Methods The diagnosis and treatment of one case of giant subgaleal hematoma complicated with intraorbital hematoma as the first presentation of CML were reported. Literature review was conducted by using the keywords of subgaleal hematoma and chronic myeloid leukemia in English and Chinese from PubMed, Wanfang Data, Chongqing VIP, SinoMed and CNKI.Results The male patient was aged 14 years old. Skull MRI showed subgaleal hematoma complicated with intraorbital hematoma. He was diagnosed with CML-CP by myelogram analysis. He received ultrasound-guided hematoma puncture with pressure dressing, given with leukapheresis, hydroxyurea, cytarabine and imatinib, a tyrosine kinase inhibitor. During 2-year follow-up, he obtained stable condition and normal quality of life. Two cases of CML presenting with subgaleal hematoma as the initial manifestation were retrieved. One case received cranial CT scan and found no abnormality, and CT scan of the other case prompted subgaleal hematoma; one case underwent hematoma puncture combined with pressure dressing, and the other case received incision and drainage of subgaleal hematoma. Fair clinical prognosis was achieved in two cases. Conclusions CML-CP patients presenting with giant subgaleal hematoma complicated with intraorbital hematoma should promptly receive hematoma puncture in combination with chemotherapy and leukapheresis, etc. In addition, tyrosine kinase inhibitor should be promptly given to enhance clinical prognosis.

Keywords

• |chronic myeloid leukemia|subgaleal hematoma|intraorbital hematoma