Alqatta Wail
Department of General and Visceral Surgery, Ibn Sina Hospital, Sanaa, Yemen.
J Surg Case Rep. 2025 Jul 8;2025(7):rjaf485. doi: 10.1093/jscr/rjaf485. eCollection 2025 Jul.
Giant splenomegaly is an uncommon but significant complication of chronic myeloid leukemia (CML), often causing substantial morbidity. While tyrosine kinase inhibitors have revolutionized CML treatment, splenectomy remains necessary in selected cases, particularly when there is symptomatic hypersplenism, compressive symptoms, or risk of splenic rupture. This case describes a 35-year-old male with chronic-phase CML who presented with progressive abdominal distension, early satiety, and anemia due to massive splenomegaly. Abdominal ultrasound revealed a spleen measuring 40 cm, extending into the pelvis. Despite optimized therapy, symptoms persisted. After multidisciplinary assessment and preoperative vaccination, the patient underwent an open splenectomy. The procedure, though technically challenging, was completed without complications. Histopathology confirmed leukemic infiltration of the spleen. The patient's postoperative course was uneventful, with no adverse events. This case underscores splenectomy as a viable and effective therapeutic option in selected CML patients with symptomatic giant splenomegaly.
巨脾是慢性髓细胞白血病（CML）一种不常见但严重的并发症，常导致显著的发病率。虽然酪氨酸激酶抑制剂彻底改变了CML的治疗方式，但在某些特定情况下脾切除术仍然是必要的，特别是当出现有症状的脾功能亢进、压迫症状或脾破裂风险时。本病例描述了一名35岁的慢性期CML男性患者，因巨大脾肿大出现进行性腹胀、早饱及贫血。腹部超声显示脾脏大小为40厘米，延伸至盆腔。尽管进行了优化治疗，症状仍持续存在。经过多学科评估和术前接种疫苗后，患者接受了开放性脾切除术。该手术虽然在技术上具有挑战性，但顺利完成且无并发症。组织病理学证实脾脏有白血病浸润。患者术后过程平稳，无不良事件。本病例强调了脾切除术对于某些有症状的巨脾CML患者是一种可行且有效的治疗选择。
