Case Report: life-threatening haemothorax due to extramedullary haematopoiesis in a patient with Beta-thalassaemia major

Introduction: Extramedullary haematopoiesis is a rare compensatory phenomenon occurring in haematologic disorders such as thalassaemia. While typically asymptomatic, it can rarely lead to life-threatening complications, including spontaneous haemothorax. Case presentation: A 60-year-old man with beta-thalassaemia major and a history of extramedullary haematopoiesis presented to the emergency department with acute chest pain, dyspnoea, and hypotension. Imaging revealed a massive left haemothorax secondary to bleeding from a paravertebral extramedullary haematopoiesis mass. The patient was managed with chest tube drainage, vasopressor support, blood transfusions, and low-dose radiotherapy targeted at the bleeding site. Discussion: Haemothorax is an exceptional complication of extramedullary haematopoiesis. Diagnosis requires a high index of suspicion, and management combines haemodynamic stabilization, surgical or radiological intervention, and long-term control of haematopoiesis. Radiotherapy plays a key role in preventing recurrence. Conclusion: This case highlights the importance of recognizing extramedullary haematopoiesis as a potential cause of spontaneous haemothorax in patients with thalassaemia and underscores the value of a multidisciplinary approach involving intensive care, hematology, thoracic surgery, and radiation oncology.