Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3206-3212
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3206
Myomatous erythrocytosis syndrome: A case report
Xin-Yu Shu, Na Chen, Bi-Yun Chen, Hui-Xia Yang, Hui Bi
Xin-Yu Shu, Bi-Yun Chen, Hui-Xia Yang, Hui Bi, Department of Obstetrics and Gynaecology, Peking University First Hospital, Beijing 100034, China
Na Chen, Department of Obstetrics and Gynaecology, The Hospital of Cang Town, Cangzhou 223900, Hebei Province, China
Author contributions: Shu XY wrote the manuscript; Chen N was involved in the acquisition of the data; Chen BY participated in manuscript writing; Yang HX revised the manuscript; Bi H performed the operation and revised the manuscript critically for important intellectual content; and All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Bi, MD, Chief Doctor, Department of Obstetrics and Gynaecology, Peking University First Hospital, Xishiku Street, Beijing 100034, China. bihuipku@163.com
Received: October 1, 2021
Peer-review started: October 1, 2021
First decision: January 11, 2022
Revised: January 20, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 6, 2022
Processing time: 179 Days and 8.2 Hours
Abstract
BACKGROUND

Uterine myoma is the most common benign tumor among women and is often accompanied by anemia. Here, we report the case of a patient with a very large leiomyoma but with a hemoglobin level as high as 197 g/L. After undergoing hysterectomy, all her hematological parameters returned to normal. Immunohistochemical staining of her myoma for erythropoietin showed strong positivity, which suggested that erythropoietin may be the cause of her erythrocytosis. A multidisciplinary team played a significant role in treating the disease.

CASE SUMMARY

A 47-year-old woman visited our department complaining that her abdomen had been continuously growing for the past 2 years. After careful examinations, she was suspected of having a very large leiomyoma. She was also diagnosed with erythrocytosis because her RBC count was 6.49 × 1012/L, hemoglobin was 197 g/L. Following a multidisciplinary team consultation, bilateral ureteral stents were placed, and 800 mL blood was removed by phlebotomy. The patient then underwent hysterectomy and bilateral salpingectomy. She recovered well from the operation, and her hemoglobin level decreased sharply following the surgery. Low-molecular-weight heparin was administered daily to prevent postoperative thrombosis. She was discharged from the hospital on the fourth postoperative day. Two months later, all her hematological parameters returned to normal. Pathological analysis of the myoma revealed that it was a benign leiomyoma, with partial hyalinization, and strong positivity for erythropoietin in immunohistochemical staining suggested that erythropoietin may be responsible for the erythrocytosis.

CONCLUSION

Erythropoietin ectopically produced from the myoma was responsible for the erythrocytosis in this patient. A multidisciplinary team is strongly recommended.

Keywords: Myomatous erythrocytosis syndrome; Erythrocytosis; Uterine myoma; Erythropoietin; Multiple disciplinary team; Case report

Core Tip: Despite chronic lung disease and malignant tumors, uterine myoma can also be the cause of secondary erythrocytosis, the mechanisms of which may be ectopically produced erythropoietin originating from the leiomyoma. A multidisciplinary team is strongly recommended to ensure that the patient has received the optimal treatment and has a good prognosis.