Successful treatment for a patient with cancer of the duodenal papilla associated with idiopathic thrombocytopenic purpura.

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  • 特発性血小板減少性紫斑病を併存した十二指腸乳頭部癌の１例

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Abstract

We successfully treated a patient with cancer of the duodenal papilla associated with idiopathic thrombocytopenic purpura (ITP), who was on high dose steroid regimen, by performing high-dose immunoglobulin therapy and a splenectomy prior to radical operation. The patient was a 66-year-old woman. After reducing the dose of steroid and confirming an increase in platelet count from 132, 000 to 470, 000/μl, the patient underwent a radical operation (pylorus preserving pancreatoduodenectomy with lymph node dissection) for the cancer of the duodenal papilla. During and after surgery, no bleeding tendency occured. The postoperative course was unevetful. After discharge, the patient has been followed at our outpatient clinic and the platelet count has been within normal range. In case of ITP, high-dose immunogulobulin therapy and splenectomy are expected to increase platelet count successfully in a short time without any marked adverse reactions. This combination therapy and the second staged radical operation seem to be a good option in cases requiring invasive operations like the present case.

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