Priapism as an Initial Manifestation of Chronic Myeloid Leukemia: A Case Report

Priapism is an urological emergency in which the corpora cavernosa undergoes necrosis and fibrosis that may result in erectile dysfunction, if left untreated. As with many medical emergencies, early intervention allows the best chance for functional recovery. Low-flow priapism is a rare complication of leukemia resulting in hyperviscosity due to high leukocytes with leukostasis and is most frequently found in chronic myeloid leukemia (CML). Herein, we report a case of priapism in a 24-year-old male caused by CML with presentation of very high leukocytes count of 387800/mm^3 and 29% blast cells. He suffered from persistent erection of the penis and was referred to our emergency department by a local clinic. CML was well documented by serial examination, including peripheral blood smear and bone marrow aspiration with biopsy. Emergency management was initiated with aspiration of blood from the corpus cavernosum, and the erection was relieved. Imatinib combined with allopurinol and hydroxyurea was prescribed and the leukocytes count returned to normal range 3 weeks later. This case illustrates the importance of emergency physicians in the diagnosis and management of patients with persistent priapism unrelated to sexual stimulation or desire.