Hemolytic anemia and benign pelvic tumors. A case report

BACKGROUND: Hemolytic anemia associated with benign pelvic neoplasms is very rare. Sixteen cases have been reported in the English-language literature. CASE: A 27-year-old woman complained of dizziness, fatigue and headache. Physical examination revealed jaundice and mild tachycardia. Laboratory evaluation indicated intravascular hemolysis, and workups for hematologic and infectious disease etiologies were negative. Multiple blood transfusions and steroids failed. Computed tomography showed a large, complex pelvic mass (10 x 10 x 6 cm). Exploratory laparotomy and excision of bilateral dermoid cysts were performed, and the anemia resolved. The patient was healthy, without recurrence, seven years later. CONCLUSION: It is important to seek to identify pelvic tumors in patients presenting with hemolytic anemia because this condition is often resistant to standard medical therapy and resolves only after removal of the neoplasm.