Abstract

Herewith, we report a 57 year-old postmenopausal Caucasian lady who presented with a large pelvi-abdominal mass and Haemoglobin (Hb) level of 23.5 g/dl. The latter could possibly be the highest Hb level reported in literature secondary to fibroid uterus. She had an HCT of 69.9% and Bilirubin of 37.6 mg/dL. Both ultrasound scan and CT for abdomen and pelvis suggested a large fibroid uterus. A provisional diagnosis of Myomatous Erythrocytosis Syndrome was made, and she was considered for total abdominal hysterectomy + Bilateral salpingo-oophorectomy. The plan was to normalise her Hb and HCT before surgery. While awaiting her surgery the patient developed an episode of rectal bleeding for which she underwent both OGD and colonoscopy. She was diagnosed with Grade 2 oesophagitis, large duodenal ulcer, and diverticular disease. A few weeks later, she was fit for surgery and a total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histology report confirmed fibroid uterus with no evidence of sarcomatous changes. Her haemoglobin remained normal 8 months later.

Keywords: Polycythaemia; Fibroid; Myomatous Erythrocytosis Syndrome

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