title: [A case of recurrent rectal cancer with idiopathic thrombocytopenic purpura showing rapid progression, suggesting disseminated intravascular coagulopathy].
abstract: A 64-year-old female with idiopathic thrombocytopenic purpura(ITP)was admitted to our hospital under the diagnosis of rectal cancer. Intersphincteric resection and splenectomy were performed after high-dose gamma globulin therapy. Thirteen months after the surgery, she suffered from a local recurrence and groin and pelvic lymph node metastases. Radiotherapy was planned before curative resection. During radiation, she complained of severe back pain and high fever with severe thrombocytopenia, and was admitted to our hospital. The examinations revealed disseminated intravascular coagulopathy(DIC), probably induced by multiple bone and hepatic metastases. Although anti-DIC therapy and chemotherapy with FOLFIRI were performed, thrombocytopenia did not improve, and she died of cancer progression about 2 months after admission. We report a case ofDIC induced by cancer progression with ITP. Since thrombocytopenia may be induced by either DIC or ITP, selecting a treatment for such a patient is difficult. We report the present case in detail and discuss findings from the literature.
authors.affiliation: Dept. of Frontier Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Gaku
authors.initials: G
authors.lastname: Ohira
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyauchi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tohma
authors.forename: Mari
authors.initials: M
authors.lastname: Kuboshima
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoneyama
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D018450:Disease Progression; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications*; D012004:Rectal Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy; D012008:Recurrence