Abstract BackgroundErythropoietin-producing uterine myoma can cause various complications such as arterial or venous thrombosis and bleeding. Therefore, caution is required in the anesthetic management of affected patients.Case presentationA 57-year-old female was suspected to have an erythropoietin-producing uterine myoma and was scheduled to undergo an abdominal total hysterectomy and bilateral salpingo-oophorectomy. Preoperative levels of hemoglobin and erythropoietin were 21.9?g/dl (normal 11.5–15?g/dl) and 23.2?IU/ml (normal 4.2–23.7?IU/ml), respectively. Preoperative phlebotomy and isovolemic hemodilution were performed to prevent arterial and venous thrombosis, following previous evidence that a hemoglobin level ?16?g/dl reduces the occurrence of polycythemia vera-related complications. Fondaparinux 2.5?mg was subcutaneously injected once daily after the operation, resulting in a good perioperative course without major complications.ConclusionHerein, we have described a successful perioperative management of a patient with erythropoietin-producing uterine myoma. Our findings in this case suggest that this combination of antithrombotic therapies can facilitate anesthetic management of patients with this disease.
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