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Chronic myeloid leukaemia presenting as priapism
Abstract
Background: Patients with chronic myeloid leukemia (CML) have diverse modes of clinical presentation. Priapism is a rare clinical presentation of CML.
Aim: To report two cases of CML who first presented as priapism at the University of Port Harcourt Teaching Hospital (UPTH).
Case report: Case notes of two patients who presented to the Urology Unit of UPTH between December 2008 and October 2011 with priapism and CML were reviewed. Their clinical features, findings on physical examination, results of investigations, treatment modalities and outcome of treatment were documented. Case 1 was a 60-year-old man who had splenomegaly for two years and six months after splenectomy developed priapism. White cell count at presentation was 360 x 109/L; he was
Philadelphia chromosome positive. Case 2 was a 26-year-old man who presented with priapism. In the course of evaluation, he was discovered to have a White Blood Cell (WBC) count of 365 x 109/L. Both cases had surgical intervention to achieve detumescence. Thereafter, they were commenced on chemotherapy. Both patients developed erectile dysfunction after treatment because of late presentation.
Conclusion: Though rare, CML may present as priapism. A high index of suspicion will aid diagnosis. Full haematological work-up should be the standard practice in all patients presenting with priapism. Surgical intervention is necessary in cases due to myeloproliferative disorders.
Keywords: Priapism, Chronic myeloid leukaemia, Hyperleucocytosis
Aim: To report two cases of CML who first presented as priapism at the University of Port Harcourt Teaching Hospital (UPTH).
Case report: Case notes of two patients who presented to the Urology Unit of UPTH between December 2008 and October 2011 with priapism and CML were reviewed. Their clinical features, findings on physical examination, results of investigations, treatment modalities and outcome of treatment were documented. Case 1 was a 60-year-old man who had splenomegaly for two years and six months after splenectomy developed priapism. White cell count at presentation was 360 x 109/L; he was
Philadelphia chromosome positive. Case 2 was a 26-year-old man who presented with priapism. In the course of evaluation, he was discovered to have a White Blood Cell (WBC) count of 365 x 109/L. Both cases had surgical intervention to achieve detumescence. Thereafter, they were commenced on chemotherapy. Both patients developed erectile dysfunction after treatment because of late presentation.
Conclusion: Though rare, CML may present as priapism. A high index of suspicion will aid diagnosis. Full haematological work-up should be the standard practice in all patients presenting with priapism. Surgical intervention is necessary in cases due to myeloproliferative disorders.
Keywords: Priapism, Chronic myeloid leukaemia, Hyperleucocytosis
