Pelvic extramedullary hematopoiesis with life‐threatening hemorrhage: a case report
Dublin Core
Title
Pelvic extramedullary hematopoiesis with life‐threatening hemorrhage: a case report
Subject
Extramedullary hematopoiesis, Thalassemia major, Pelvic mass, Chronic anemia, Blood transfusion, Splenic
artery embolization, Hemorrhagic shock
artery embolization, Hemorrhagic shock
Description
Abstract
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 compensa-
tory mechanism in which blood-producing tissue forms outside the bone marrow. The occurrence of extramedul-
lary 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. Com-
plete resection was not feasible due to significant hemorrhage, necessitating postoperative embolization for hemo-
stasis. 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 emboli-
zation provides a valuable therapeutic approach to managing transfusion burden in such cases.
Keywords Extramedullary hematopoiesis, Thalassemia major, Pelvic mass, Chronic anemia, Blood transfusion, Splenic
artery embolization, Hemorrhagic shock
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 compensa-
tory mechanism in which blood-producing tissue forms outside the bone marrow. The occurrence of extramedul-
lary 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. Com-
plete resection was not feasible due to significant hemorrhage, necessitating postoperative embolization for hemo-
stasis. 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 emboli-
zation provides a valuable therapeutic approach to managing transfusion burden in such cases.
Keywords Extramedullary hematopoiesis, Thalassemia major, Pelvic mass, Chronic anemia, Blood transfusion, Splenic
artery embolization, Hemorrhagic shock
Creator
Zainab Habbash1†, Ali Hassan1*† , Sawsan Kadhem1
, Nawra Mujbel1 and Mahdi Aljawad2
, Nawra Mujbel1 and Mahdi Aljawad2
Source
https://doi.org/10.1186/s12245-025-00834-2
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Zainab Habbash1†, Ali Hassan1*† , Sawsan Kadhem1
, Nawra Mujbel1 and Mahdi Aljawad2, “Pelvic extramedullary hematopoiesis with life‐threatening hemorrhage: a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12668.