Myomatous erythrocytosis syndrome with unusually normal serum erythropoietin levels
3
Issued Date
2025-12-18
Resource Type
eISSN
1757790X
Scopus ID
2-s2.0-105025171496
Pubmed ID
41412955
Journal Title
BMJ Case Reports
Volume
18
Issue
12
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ Case Reports Vol.18 No.12 (2025)
Suggested Citation
Nuchpramool P., Kijmanawat A., Nanthatanti N., Kulthamrongsri N. Myomatous erythrocytosis syndrome with unusually normal serum erythropoietin levels. BMJ Case Reports Vol.18 No.12 (2025). doi:10.1136/bcr-2025-267028 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113695
Title
Myomatous erythrocytosis syndrome with unusually normal serum erythropoietin levels
Corresponding Author(s)
Other Contributor(s)
Abstract
Myoma uteri is the most common benign tumour in women, but myomatous erythrocytosis syndrome (MES) is rare. MES is characterised by erythrocytosis, a myomatous uterus and blood normalization after hysterectomy or myomectomy. It increases the risk of thromboembolic events, making early recognition crucial.A premenopausal, nulliparous woman in her 50s with dyslipidaemia and obesity presented with a 20-week-sized abdominopelvic mass but no abnormal uterine bleeding. CT imaging revealed a large right adnexal mass. Lab tests showed isolated erythrocytosis with normal tumour markers and serum erythropoietin (Epo). Hysterectomy and bilateral salpingo-oophorectomy confirmed multiple uterine myomas, the largest measuring 19.5 cm, along with a right ovarian haemorrhagic cyst. Postoperatively, her blood levels normalised, confirming MES.The exact mechanism remains unclear but may involve Epo production. While Epo is often linked to myomas, some cases, like ours, show normal levels, highlighting the need for further research to understand MES and develop targeted treatments.