ABSTRACT
Uterine leiomyomas are the most common benign pelvic tumours in females. Rarely they are associated with symptoms of ectopic hormone production. One of these syndromes is the myomatous erythrocytosis syndrome, which is a triad of polycythaemia, fibroid[s] and resolution of the polycythaemia after hysterectomy. The case presented is of a post-menopausal lady found to have a Hb of 21 during workup of a pelvic mass. A diagnosis of secondary polycythemia due to ectopic erythropoietin production by the fibroid was made. After five sessions of phlebotomiesa target Hb of 15 was obtained for surgery. The haematological values restored to normal three days post-operatively. It has been postulated that all fibroids produce erythropoietin. Recognition and proper management of this condition is important to differentiate between primary and secondary polycythaemia as primary polycythemia is a thromboembolic condition, to avoid un-necessary investigations and to prevent any complications secondary polycythaemia may have per-operatively