Severe Thrombocytopenia Cured After Ovarian Tumours Surgical Removal
Cosmina Andreea Catoiu1, Ioan Corneliu Tanase1,2*, Bogdan Gabriel Stoica1,2 and Sorin Constantin Paun1,2
1Department of Surgery, Emergency Hospital - Bucharest, Romania
2University of Medicine and Pharmacy Carol Davila Bucharest, Romania
*Corresponding Author: Ioan Corneliu Tanase, Assistant Professor, University of Medicine and Pharmacy Carol Davila Bucharest, Department of Surgery, Emergency Hospital - Bucharest, Romania.
October 27, 2021; Published: November 10, 2021
Autoimmune thrombocytopenia (ITP) is an acquired immune-mediated disorder characterized by early platelet destruction due to antiplatelet autoantibodies. Although progress in the immunopathology of ITP has been done, pathogenesis of ITP remains yet to be determined, and currently there are no specific tests that can diagnose this disease, often being a diagnosis of exclusion. We describe the case of a 65-year-old woman admitted in the surgical department with progressively worsening abdominal distension for the past 12 months. Imagistic investigations showed a giant cystic tumour with a distinct septum and inhomogeneous internal content, which extended from the pelvis all the way through the upper abdomen, suggesting a complex left ovarian cyst with no lymph nodes or other intraabdominal tumoural masses. Blood tests showed mild anaemia, and severe thrombocytopenia with a platelet count of 21.000/μL refractory to treatment, anisocytosis with micro- and macro-thrombocytes. Coagulation profile was normal. The patient underwent, total hysterectomy with bilateral adnexectomy pelvic and inter-aortic-caval lymphadenectomy, with the excision of the multiloculated ovarian mass with haemorrhagic fluid and solid components. The histopathological exam showed an ovarian mucinous borderline tumour without stromal or regional lymph node invasion staged T1aN0M0. In the postoperative period we observed the resolution of the thrombocytopaenia, the patient’s platelet count remaining stable around 120000/µL.
This report highlights the causality between the complete ITP remissions after tumour excision suggesting that a possible paraneoplastic implication should always be investigated in such cases. The ovarian tumour presence may be frequently omitted and refractory thrombocytopenia attributed to other causes or classified as idiopathic
Keywords: Thrombocytopenia; Ovarian Tumour; Surgery
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