# A rare presentation of spontaneous splenic rupture from plasma cell leukaemia—a case report

## TL;DR

An 82-year-old man with plasma cell leukemia experienced a rare spontaneous splenic rupture and recovered after treatment.

## Contribution

This case highlights plasma cell leukemia as a rare cause of spontaneous splenic rupture.

## Key findings

- Spontaneous splenic rupture was diagnosed in a patient with plasma cell leukemia.
- The patient recovered after splenectomy and chemotherapy.
- Plasma cell leukemia can present with splenic complications due to thrombocytopenia.

## Abstract

Spontaneous/atraumatic splenic rupture is rare, and often associated with underlying infectious disease, or haematological malignancy. Plasma cell leukaemia (PCL) is a rare and aggressive subtype of multiple myeloma, with a higher prevalence of hepatosplenomegaly with a bleeding diathesis from secondary to thrombocytopaenia. We report the case of an 82-year-old male presenting to the emergency department with altered mentation and complaints of left abdominal pain. He presented with haemorrhagic shock. Imaging revealed a spontaneous splenic rupture. He underwent emergency laparotomy and splenectomy for which the histopathology yielded a diagnosis of PCL as the cause for rupture. He received four courses of bortezomib and hyperCVAD 1A therapy. After a long 64-day admission, he recovered well and was discharged home with outpatient haematology/oncology follow-up.