Acute Myeloid Leukemia Presenting As Spontaneous Splenic Rupture: A Case Report

Abstract

Spontaneous splenic rupture (SSR) is a rare but potentially life-threatening condition that may occur in the setting of underlying splenic pathology, including hematologic malignancies such as acute myeloid leukemia (AML). We report the case of a 28-year-old man who presented with sudden-onset severe abdominal pain. Imaging revealed massive hemoperitoneum secondary to SSR. Laboratory investigations demonstrated severe anemia, thrombocytopenia, leukocytosis, and circulating blasts on peripheral smear, with normal coagulation parameters. The patient underwent urgent splenectomy, and histopathological examination showed extensive infiltration by myeloperoxidase-positive blasts. Bone marrow aspiration and immunophenotyping confirmed AML with a complex karyotype and adverse prognostic features. Despite initiation of induction chemotherapy, the clinical course was complicated by septic shock leading to death. This case highlights SSR as a rare initial manifestation of AML and emphasizes the importance of early recognition, prompt imaging, and multidisciplinary management to improve clinical outcomes.