title: Hemoperitoneum: an unusual presentation of chronic granulocytic leukemia in a pediatric patient.
abstract: Chronic granulocytic leukemia (CGL) is a rare hematologic disease in pediatric patients. It usually presents with insidious symptoms. However, some cases may have an atypical presentation. We report herein the case of a 13-year-old female admitted to the emergency department with acute abdomen. She had hyperleukocytosis of 500.0 × 1000 cells/mm suggestive of CGL. A paracentesis was performed due to abdominal compartment syndrome that demonstrated hemoperitoneum. At laparotomy, a ruptured ovarian mass was found with multiple tumor implants in the serosal surface. Pathology revealed a CGL-infiltrated ovary. The patient is currently stable, has finished adjuvant chemotherapy, and is at 24 months of follow-up. To our knowledge, this is the first report of such a case.
authors.affiliation: From the *Department of Pediatric Emergency Medicine, †Department of Pediatric Hemato-oncology, ‡Department of Pediatric Surgery, §Instituto Nacional de Pediatria, and ∥Department of Pediatric Surgery, Mexico City, Mexico.
authors.forename: Eduardo Cazares
authors.initials: EC
authors.lastname: Ramirez
authors.forename: Mario Alberto Acosta
authors.initials: MA
authors.lastname: Bastidas
authors.forename: Norma Candelaria Lopez
authors.initials: NC
authors.lastname: Santiago
authors.forename: Rodrigo Diaz
authors.initials: RD
authors.lastname: Machorro
authors.forename: Paulina
authors.initials: P
authors.lastname: Del Mazo Ruiz
authors.forename: Jaime
authors.initials: J
authors.lastname: Shalkow-Klincovstein
mesh_terms: D000293:Adolescent; D005260:Female; D006465:Hemoperitoneum / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007621:Karyotyping; D007813:Laparotomy / Q000379:methods*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010052:Ovariectomy