About uterine fibroids with secondary polycythemia in 1 case.docVIP

 PAGE \* MERGEFORMAT 5 About uterine fibroids with secondary polycythemia in 1 case [Keywords:] uterine fibroids; secondary polycythemia 1 Case information Patients, female, 57 years old. Postmenopausal 5 years, found that “diabetes and hypertension” 5 years, 3 perceived increases in the lower abdomen, there face, half red palm skin, dizziness, headache, lower extremity edema, oliguria 2 months. because of lower extremity edema, oliguria, with “Type 2 diabetes, diabetic nephropathy?” admitted to Endocrinology, admission blood glucose and blood pressure were well controlled, routine blood examination revealed HGB up to 248g / L, bone marrow biopsy report “ myeloproliferative disorders. “hematologic report” Polycythemia. “ Whole abdominal B-said: “renal water, ureter expansion, the substantial holder abdominal cavity, uterine fibroids may be considered.” Tumor markers CEA, AFP, CA125 were normal. KUB + IVP said: “the right kidney water, right kidney dysfunction, renal suspicious developing some small light, water left kidney, renal dysfunction, left fallopian tube is not developing. “urological consultation to consider a huge abdominal mass oppression within the ureter may be recommended abdominal CT. Abdominal CT said: “in the lower abdomen and pelvic lesions within the large, considering the possibility of large uterine fibroids, bilateral middle and lower ureteral compression, dual hydronephrosis.” gynecology consultation consider surgical indications, but HGB is too high, perioperative cardiovascular complication rate, the proposed control normal HGB after surgical treatment. hematology consultation to consider a huge uterine myoma secondary polycythemia due, bleeding can be treated. has vein bled 7 times, each time 200 ~ 300ml, review the significant improvement in blood, HGB 162g / L, transfer of gynecological surgery. Physical examination: T 36.2 ℃, P 80 times / min, R 20 times / min, BP 154/80mmHg, facial skin, dark red, with cheek, nose and mou