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Background <p>Thalassemia is an inherited blood disorder characterized by defective hemoglobin production, leading to chronic&#xa0;anemia and the necessity for lifelong blood transfusions. Extramedullary hematopoiesis is a compensatory&#xa0;mechanism in which blood-producing tissue forms outside the bone marrow. The occurrence of extramedullary&#xa0;hematopoiesis as a pelvic mass is rare.</p> Case Presentation <p>We report the case of a 44-year-old woman with β-thalassemia major who was found to have a pelvic fat-containing&#xa0;mass incidentally on imaging. A diagnostic laparotomy revealed a highly vascular mass. Complete resection was not&#xa0;feasible due to significant hemorrhage, necessitating postoperative embolization for hemostasis. Histopathological&#xa0;examination confirmed the diagnosis of extramedullary hematopoiesis. Postoperatively, the patient developed&#xa0;severe anemia, requiring frequent transfusions. To reduce transfusion dependency, splenic artery embolization was&#xa0;performed.&#xa0;</p> Conclusion <p>This case underscores the rare presentation of extramedullary hematopoiesis as a pelvic mass. Accurate diagnosis is&#xa0;critical, as surgical removal can result in severe hemorrhage and worsening anemia. Splenic artery embolization&#xa0;provides a valuable therapeutic approach to managing transfusion burden in such cases.</p>

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Pelvic extramedullary hematopoiesis with life-threatening hemorrhage: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月24日

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  • Zainab Habbash,
  • Ali Hassan,
  • Sawsan Kadhem,
  • Nawra Mujbel,
  • Mahdi Aljawad

摘要

Background

Thalassemia is an inherited blood disorder characterized by defective hemoglobin production, leading to chronic anemia and the necessity for lifelong blood transfusions. Extramedullary hematopoiesis is a compensatory mechanism in which blood-producing tissue forms outside the bone marrow. The occurrence of extramedullary hematopoiesis as a pelvic mass is rare.

Case Presentation

We report the case of a 44-year-old woman with β-thalassemia major who was found to have a pelvic fat-containing mass incidentally on imaging. A diagnostic laparotomy revealed a highly vascular mass. Complete resection was not feasible due to significant hemorrhage, necessitating postoperative embolization for hemostasis. Histopathological examination confirmed the diagnosis of extramedullary hematopoiesis. Postoperatively, the patient developed severe anemia, requiring frequent transfusions. To reduce transfusion dependency, splenic artery embolization was performed. 

Conclusion

This case underscores the rare presentation of extramedullary hematopoiesis as a pelvic mass. Accurate diagnosis is critical, as surgical removal can result in severe hemorrhage and worsening anemia. Splenic artery embolization provides a valuable therapeutic approach to managing transfusion burden in such cases.