title: [Cutaneous involvement in chronic myelomonocytic leukemia--a possible indicator for transition into acute leucaemia].
abstract: BACKGROUND
  A 83-year old patient with "myelodysplastic / myeloproliferative neoplasia", type chronic myelomonocytic leukemia (CMML), presented at our clinic with an intermittent bleeding, growing tumour located at the glabella. The tumour occurred after a trauma, and thus the suspected diagnosis was pyogenic granuloma. In the context of outpatient care, a severe and persistent bleeding occurred, so that the patient was hospitalized. EXAMINATIONS AND DIAGNOSES: Histopathological analyses of the excized tumour nodule revealed specific cutaneous leukemic infiltrates. Laboratory check-up showed thrombocytopenia with thrombocytopathy and hypofibrinogenaemia.
  
  
  METHODS
  Despite appropriate intraoperative hemostasis, sustained post-treatment bleeding occurred, necessitating the application of several erythrocyte concentrates as well as substitution of prothrombin, fibrinogen, and factor XIII. After stationary dismissal, the patient experienced a transition into acute myelomonocytic leukemia and died a short time thereafter.
  
  
  CONCLUSIONS
  Skin lesions are frequent in "myelodysplastic / myeloproliferative neoplasias" and myelodysplastic syndromes. Specific cutaneous infiltrates associated with CMML may be a clinical indicator for a transition into acute leukemia.
authors.forename: Tabea
authors.initials: T
authors.lastname: Nußbaum
authors.forename: Christian
authors.initials: C
authors.lastname: Tigges
authors.forename: Julia
authors.initials: J
authors.lastname: Kirschke
authors.forename: Frank
authors.initials: F
authors.lastname: Oellig
authors.forename: Ulla
authors.initials: U
authors.lastname: v Verschuer
authors.forename: Ulrike
authors.initials: U
authors.lastname: Wieland
authors.forename: Alexander
authors.initials: A
authors.lastname: Kreuter
mesh_terms: D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D003937:Diagnosis, Differential; D005153:Facial Neoplasms / Q000473:pathology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015456:Leukemia, Biphenotypic, Acute / Q000473:pathology* / Q000628:therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000473:pathology* / Q000628:therapy; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy