Treating Myomatous Erythrocytosis Syndrome With Uterine Artery Embolization.

Abstract

Myomatous erythrocytosis syndrome, a form of secondary polycythemia associated with uterine leiomyomas, increases the risk of thrombosis and traditionally has been treated with hysterectomy. The patient is a 68-year-old woman with 7-year history of polycythemia initially thought to be secondary to a gastrointestinal stromal tumor that persisted after resection. A subsequent search for an alternative etiology led to the discovery of an 11.2-cm submucosal leiomyoma and likelihood of myomatous erythrocytosis syndrome. The patient declined surgical management and continued to undergo recurrent phlebotomy to maintain a hematocrit of less than 45% until consultation with an interventional radiology specialist. She underwent uterine artery embolization in July 2017, and her hematocrit has remained within normal limits through 17 months of follow-up. Uterine artery embolization is an effective alternative treatment modality for myomatous erythrocytosis syndrome.