Ovarian cyst haemorrhage as a complication of acute myelomonocytic leukaemia induction therapy.

Background: Here we present a case of acute ovarian cyst haemorrhage in a young female during induction therapy for acute myelomonocytic leukaemia (AMML).

Case Presentation: A patient undergoing chemotherapy on the AML19 trial for AMML developed severe abdominal pain and haemodynamic compromise during cycle 2 of fludarabine, cytarabine and idarubicin. The patient was found to have a large ruptured haemorrhagic ovarian cyst on computed tomography. She was managed conservatively due to relative haematological contraindications to surgery and haemodynamic stability following transfer to the high dependency unit. The patient had recently discontinued anticoagulation for pulmonary emboli due to thrombocytopenia.

Conclusions: This highlights the importance of recognising coexistent pathology in patients undergoing high intensity chemotherapy.