# Chronic Myelomonocytic Leukemia (CMML) as a Rare Cause of Spontaneous Atraumatic Splenic Rupture in a 65-Year-Old Male

## TL;DR

A 65-year-old man with chronic thrombocytopenia experienced a rare atraumatic splenic rupture due to undiagnosed chronic myelomonocytic leukemia.

## Contribution

Highlights CMML as a rare but critical cause of atraumatic splenic rupture in adults.

## Key findings

- The patient's splenic rupture was caused by chronic myelomonocytic leukemia (CMML).
- Delayed diagnosis led to life-threatening hemorrhagic shock requiring emergency splenectomy.
- CMML should be considered in the differential diagnosis of atraumatic splenic rupture.

## Abstract

This report describes a patient with a history of chronic thrombocytopenia who presented with splenic rupture and hemorrhagic shock in the absence of trauma. Four days earlier, the patient had visited the emergency department with symptoms of sore throat, fever, and myalgia. Due to the relatively benign presentation, further workup was deferred in favor of a presumed infectious etiology. This delay in diagnosis led to the patient presenting with life-threatening injuries, necessitating an emergent splenectomy. Subsequent evaluation revealed an underlying diagnosis of chronic myelomonocytic leukemia (CMML), which ultimately caused the splenic rupture. This case underscores the importance of considering hematologic malignancies, including rare pathologies like CMML, in the differential diagnosis of atraumatic splenic rupture (ASR).