A case report of gemcitabine treatment for duodenal cancer: the good (a sustained response) and the bad (life threatening refractory thrombotic thrombocytopenic purpura).
BACKGROUND
Adenocarcinoma of the duodenum is a rare cancer and not submitted to the type of clinical trials that guide chemotherapy treatments in other gastrointestinal malignancies.


METHODS
This case demonstrates the potential use for gemcitabine, a chemotherapy typically used in pancreas and biliary tract tumors, in this difficult to treat disease as this patient had a partial response to single agent gemcitabine. Unfortunately, this case also demonstrates one of the rare potential adverse reactions to gemcitabine, which is the development of thrombotic thrombocytopenic purpura (TTP).


CONCLUSIONS
In this case, the TTP was extremely difficult to treat but was resolved with splenectomy.
Robinson
Andrew
A
Regional Cancer Program of Sudbury Regional Hospital, Northern Ontario School of Medicine, 41 Ramsey Lake R, Sudbury, ON P3E 5J1, Canada. arobinson@hrsrh.on.ca
Clark
William F
WF
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D004379:Duodenal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009852:Omentum / Q000473:pathology; D010179:Pancreas / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000473:pathology; D011697:Purpura, Thrombotic Thrombocytopenic / Q000139:chemically induced*; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine