title: [Idiopathic thrombocytopenic purpura during chemotherapy for liver metastasis of rectal cancer].
abstract: Neoadjuavnt chemotherapy for liver metastasis of colorectal cancer implies issues about timing for resection and management for adverse events due to chemotherapy.
  
  
  METHODS
  A 50-year-old male patient with synchronous liver metastasis from rectal cancer had a surgery for primary lesion followed by neo-adjuvant chemotherapy for liver resection. Chemotherapy of bevacizumab + mFOLFOX6 achieved a partial response for liver metastasis. When we planned a liver resection, platelet count decreased to 1.4 × 10(4)/µL. The patient was diagnosed as idiopathic thrombocytopenic purpura (ITP) by several examinations but medical control including steroids failed. Partial splenic artery embolization could recover platelet count successfully. However, during the period of therapy for ITP, liver metastasis became unresectable. The patient is currently treated by FOLFIRI and with stable disease for three months.
  
  
  CONCLUSIONS
  NeoPyloriadjuvant chemotherapy for respectable liver metastasis should be considered carefully in terms of timing for resection and prompt management for adverse events.
authors.affiliation: Dept. of Surgery, Suita Municipal Hospital.
authors.forename: Kohei
authors.initials: K
authors.lastname: Murata
authors.forename: Koji
authors.initials: K
authors.lastname: Mikami
authors.forename: Masahide
authors.initials: M
authors.lastname: Yamada
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ide
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Owada
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nishigaki
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Nagase
authors.forename: Ryota
authors.initials: R
authors.lastname: Mukai
authors.forename: Toru
authors.initials: T
authors.lastname: Momozane
authors.forename: Masahiro
authors.initials: M
authors.lastname: Murakami
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Okada
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Chikara
authors.initials: C
authors.lastname: Ebisui
authors.forename: Hideoki
authors.initials: H
authors.lastname: Yokouchi
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Kinuta
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D000068258:Bevacizumab; D004621:Embolization, Therapeutic; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced* / Q000628:therapy*; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D013157:Splenic Artery
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil