Thrombocytopenia due to hypersplenism in oncological disease: partial splenic embolization during palliative treatment.
Hypersplenism is excess activity of the spleen, resulting in peripheral pancytopenia that predominates in platelet cell lines. Pancytopenia can be limited by reducing the volume of the functional spleen. However, in patients in very poor general condition, a splenectomy may not be possible, due to the risks of surgery and postoperative infection. Another therapeutic alternative in these patients is to reduce the volume of the spleen by super selective percutaneous splenic embolization. We report three cases of peripheral thrombocytopenia due to hypersplenism with a platelet count between 60,000 and 80,000/mm(3), which made it impossible to continue or start a chemotherapy protocol in these patients. For these patients, super selective partial embolization of the splenic parenchyma, with uncharged microspheres (250 microns) quickly resulted in a platelet count above 150,000/mm(3) so that chemotherapy could be continued or initiated.
Service de radiologie interventionnelle, centre de lutte contre le cancer Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France. Electronic address: beji.radio@gmail.com.
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Beji
Service d'oncologie digestive, centre de lutte contre le cancer Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France.
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De La Fouchardière
Service d'oncologie digestive, centre de lutte contre le cancer Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France.
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Desseigne
Service de radiologie interventionnelle, centre de lutte contre le cancer Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France.
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Thiesse
Service de radiologie interventionnelle, centre de lutte contre le cancer Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France.
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Richioud
Service de radiologie interventionnelle, centre de lutte contre le cancer Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France.
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Pilleul
D000230:Adenocarcinoma / Q000150:complications; D000328:Adult; D001650:Bile Duct Neoplasms / Q000150:complications; D018281:Cholangiocarcinoma / Q000150:complications; D015179:Colorectal Neoplasms / Q000150:complications; D004621:Embolization, Therapeutic; D006801:Humans; D006971:Hypersplenism / Q000150:complications* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D013154:Spleen / Q000098:blood supply*; D013921:Thrombocytopenia / Q000209:etiology* / Q000628:therapy*
Hypersplenism; Interventional radiology; Partial splenic embolization; Portal hypertension; Thrombocytopenia