Alireza Zakaryaei

Myomatous erythrocytosis syndrome: a critical diagnosis in women with uterine leiomyoma: a case report

Myomatous erythrocytosis syndrome is an uncommon paraneoplastic syndrome of erythrocytosis associated with benign uterine leiomyomas. Fewer than 70 cases have been reported globally, and clinical awareness remains limited. We report the case of a 45-year-old Middle Eastern premenopausal woman who presented with a several-month history of abdominal distension and a hemoglobin level of 22.5 g/dL. Imaging revealed a massive subserosal uterine leiomyoma (190 × 181 × 115 mm). Following total abdominal hysterectomy with left salpingo-oophorectomy, her hemoglobin level normalized to 15 g/dL within days. Histopathological analysis revealed no evidence of malignancy, consistent with a diagnosis of myomatous erythrocytosis syndrome. Myomatous erythrocytosis syndrome should be considered in women presenting with unexplained erythrocytosis and large uterine leiomyomas. Timely diagnosis and surgical intervention can result in hematologic normalization and help prevent life-threatening thromboembolic complications.