Hemorrhagic shock due to splenic rupture linked to refractory anaplastic myeloma

Though spontaneous splenic rupture is a well-known complication of hematologic malignancies, it is rare during myeloma. We describe an unexpected spontaneous splenic rupture in a refractory anaplastic myeloma, following first-line chemotherapy, one month after the myeloma was diagnosed. The rupture was diagnosed on a patient in shock suffering from abdominal pain. Hemodynamics was stabilized thanks to emergency surgical treatment, however, the progression of the myeloma with diffuse infiltration proved fatal. The particularly aggressive nature of this myeloma - massive tissue infiltration despite chemotherapy - underscores the severity of this rare but potentially fatal complication.