Although leiomyoma uteri are common, giant myomas are rare. The rare occurrence of erythrocytosis, myomatous uterus and persistent restoration of normal haematological values after hysterectomy is known as the myomatous erythrocytosis syndrome. A 46-year-old woman presented with progressive swelling of the abdomen by a hugely protuberant mass for three years. Clinical suspicion was of malignant ovarian tumour. Ultrasonography was inconclusive and CT revealed a huge lobulated heterogeneous soft tissue mass with intralesional vascularity. Her haemoglobin was 22.4 gr/dL and hematocrit of 56%. She underwent total abdominal hysterectomy and bilateral salpingo-ophorectomy. On tenth postoperative day her repeat haemoglobin and hematocrit was 19.5 gr/dL and 51.9% respectively. Follow up at six weeks and 6 months after surgery her haemoglobin was 16.5 gr/dL and 14.2 gr/ dL respectively and her hematocrit had regressed to 47.6% and 42.8% respectively. Giant leiomyomas can present an unusual challenge in the management.

Authors: Hafizur Rahman, Barun Kumar Sharma, Ezzat Khalda, Rashmi Pathak, Swati Dubey

Key Words: Leiomyoma, giant, erythrocytosis, myoma, uterus