Case Report: Priapism as The Clinical Presenting Feature of Chronic Myeloid Leukemia: Case Report and 20-Year Literature Review

Abstract

Priapism in chronic myeloid leukemia (CML) appears to be an infrequent manifestation as well as a crucial emergency. Here, we report an 18-year-old male presenting with a persistent erection of the penis for 20 days. We evaluated and compared the reported cases within 20 years discussing the management of priapism in CML. Cytoreductive therapy followed by leukapheresis, the administration of tyrosine kinase inhibitor, and intra-cavernosal blood aspiration may resolve the symptoms of priapism. Early intervention for cytoreduction and aspiration are the pivotal keys to successfully impeding the complications.

Priapism and chronic myeloid leukemia in an adolescent. Rare debut presentation. A case report

“…Priapism is defined as a sustained erection lasting more than 4 hours, which may or may not be related to sexual stimulation. [1][2][3] There are 2 types of priapism, high-flow and low-flow. Highflow or non-ischemic priapism occurs when there is increased blood flow in the sinusoid arteries without affecting the venous flow.…”

“…The most frequent cause is penile trauma. 1,2,4 Low-flow or ischemic priapism originates in conditions that cause low venous flow and, secondarily, there is stasis in the penile vessels. Low-flow priapism is the most common type and results in cell damage and fibrosis.…”

“…The most frequent causes are blood dyscrasias, such as sickle cell anemia and chronic myeloid leukemia (CML). 1,2,4 Priapism is considered an emergency. [1][2][3][4][5] A poor experience in diagnosis and delayed treatment have been associated with irreversible sequelae.…”

“…1,2,4 Priapism is considered an emergency. [1][2][3][4][5] A poor experience in diagnosis and delayed treatment have been associated with irreversible sequelae. 5 Failure to resolve ischemic priapism within 12 hours, 4 or any type beyond 24-48 hours, has been associated with irreversible damage and poor prognosis, 5,6 with sequelae such as erectile dysfunction, penile deformities, and psychological damage, among others.…”

“…5 Only 1-5% of priapism cases are caused by some type of leukemia and, of these, half of the priapism cases are associated with CML. 1,5,8 The most common cause of priapism in children is sickle cell anemia (65%), followed by leukemias (10%), trauma (10%), idiopathic origin (10%), and medications (5%). 3,8 Here we describe the case of a patient who presented with priapism as the initial manifestation of CML, its course, and management.…”