tINTRODUCTION: Primary myelofibrosis (MF) is a myeloproliferative neoplasm that results in debilitatingconstitutional symptoms, splenomegaly, and cytopenias. In patients with symptomatic splenomegaly,splenectomy remains a viable treatment option for MF patients with medically refractory symptomaticsplenomegaly that precludes the use of ruxolitinib.CASE PRESENTATION: We present the clinical case of a patient who was admitted to our Department toperform a splenectomy in MF as a therapeutic step prior to an allogeneic stem cell transplantation (ASCT).A laparotomic splenectomy and excision of whitish wide-spread peritoneal and omental nodulations wasperformed. There were no operative complications and the surgery was completed with minimal bloodloss. The histopathological exam revealed an extramedullary hematopoiesis in both spleen and peritonealnodules.CONCLUSION: In primary myelofibrosis it must always be kept in mind the possible presence of peri-toneal implants of extramedullary hematopoiesis and ascites of reactive genesis. We report a rare case ofperitoneal carcinomatosis-like implants of extramedullary hematopoiesis found at splenectomy for MF.
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