Cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection: a case report

Abstract Background Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by thrombocytosis and a propensity for both thrombotic and hemorrhagic events. ET rarely occurs simultaneously with colorectal cancer. Here, we report a case of colorectal cancer in an ET patient treate...

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Main Authors: Masaya Hiyoshi, Hiroaki Nozawa, Kentaro Inada, Takayoshi Koseki, Keiichi Nasu, Yasuji Seyama, Ikuo Wada, Koji Murono, Shigenobu Emoto, Manabu Kaneko, Kazuhito Sasaki, Yasutaka Shuno, Takeshi Nishikawa, Toshiaki Tanaka, Keisuke Hata, Kazushige Kawai, Tsuyoshi Maeshiro, Sachio Miyamoto, Soichiro Ishihara
Format: Article
Language:English
Published: Japan Surgical Society 2019-06-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-019-0660-3
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author Masaya Hiyoshi
Hiroaki Nozawa
Kentaro Inada
Takayoshi Koseki
Keiichi Nasu
Yasuji Seyama
Ikuo Wada
Koji Murono
Shigenobu Emoto
Manabu Kaneko
Kazuhito Sasaki
Yasutaka Shuno
Takeshi Nishikawa
Toshiaki Tanaka
Keisuke Hata
Kazushige Kawai
Tsuyoshi Maeshiro
Sachio Miyamoto
Soichiro Ishihara
author_facet Masaya Hiyoshi
Hiroaki Nozawa
Kentaro Inada
Takayoshi Koseki
Keiichi Nasu
Yasuji Seyama
Ikuo Wada
Koji Murono
Shigenobu Emoto
Manabu Kaneko
Kazuhito Sasaki
Yasutaka Shuno
Takeshi Nishikawa
Toshiaki Tanaka
Keisuke Hata
Kazushige Kawai
Tsuyoshi Maeshiro
Sachio Miyamoto
Soichiro Ishihara
author_sort Masaya Hiyoshi
collection DOAJ
description Abstract Background Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by thrombocytosis and a propensity for both thrombotic and hemorrhagic events. ET rarely occurs simultaneously with colorectal cancer. Here, we report a case of colorectal cancer in an ET patient treated using laparoscopic ileocecal resection. Case presentation A 40-year-old woman was admitted to our hospital after presenting with liver dysfunction. She had been previously diagnosed with ET; aspirin and anagrelide had been prescribed. Subsequent examination at our hospital revealed cecal cancer. Distant metastasis was absent; laparoscopic ileocecal resection was performed. Anagrelide was discontinued only on the surgery day. She was discharged on the seventh postoperative day without thrombosis or hemorrhage. However, when capecitabine and oxaliplatin were administered as adjuvant chemotherapy with continued anagrelide administration, she experienced hepatic dysfunction and thrombocytopenia; thus, anagrelide was discontinued. Five days later, her platelet count recovered. Subsequently, anagrelide and aspirin administration was resumed, without any adjuvant chemotherapy. Her liver function normalized gradually in 4 months. One-year post operation, she is well without tumor recurrence or new metastasis. Conclusions To our knowledge, this is the first report of laparoscopic colectomy performed on an ET patient receiving anagrelide. Our report shows that complications such as bleeding or thrombosis can be avoided by anagrelide administration. Contrastingly, thrombocytopenia due to anagrelide intake should be considered when chemotherapy that could cause bone marrow suppression is administered.
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spelling doaj-art-4a4f76e78dc146a7b3fffaa2fc002f402025-08-20T03:58:22ZengJapan Surgical SocietySurgical Case Reports2198-77932019-06-01511410.1186/s40792-019-0660-3Cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection: a case reportMasaya Hiyoshi0Hiroaki Nozawa1Kentaro Inada2Takayoshi Koseki3Keiichi Nasu4Yasuji Seyama5Ikuo Wada6Koji Murono7Shigenobu Emoto8Manabu Kaneko9Kazuhito Sasaki10Yasutaka Shuno11Takeshi Nishikawa12Toshiaki Tanaka13Keisuke Hata14Kazushige Kawai15Tsuyoshi Maeshiro16Sachio Miyamoto17Soichiro Ishihara18Department of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgery, Tokyo Metropolitan Bokutoh HospitalDepartment of Surgery, Tokyo Metropolitan Bokutoh HospitalDepartment of Surgery, Tokyo Metropolitan Bokutoh HospitalDepartment of Surgery, Tokyo Metropolitan Bokutoh HospitalDepartment of Surgery, Tokyo Metropolitan Bokutoh HospitalDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoDepartment of Surgery, Tokyo Metropolitan Bokutoh HospitalDepartment of Surgery, Tokyo Metropolitan Bokutoh HospitalDepartment of Surgical Oncology, Faculty of Medical Sciences, the University of TokyoAbstract Background Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by thrombocytosis and a propensity for both thrombotic and hemorrhagic events. ET rarely occurs simultaneously with colorectal cancer. Here, we report a case of colorectal cancer in an ET patient treated using laparoscopic ileocecal resection. Case presentation A 40-year-old woman was admitted to our hospital after presenting with liver dysfunction. She had been previously diagnosed with ET; aspirin and anagrelide had been prescribed. Subsequent examination at our hospital revealed cecal cancer. Distant metastasis was absent; laparoscopic ileocecal resection was performed. Anagrelide was discontinued only on the surgery day. She was discharged on the seventh postoperative day without thrombosis or hemorrhage. However, when capecitabine and oxaliplatin were administered as adjuvant chemotherapy with continued anagrelide administration, she experienced hepatic dysfunction and thrombocytopenia; thus, anagrelide was discontinued. Five days later, her platelet count recovered. Subsequently, anagrelide and aspirin administration was resumed, without any adjuvant chemotherapy. Her liver function normalized gradually in 4 months. One-year post operation, she is well without tumor recurrence or new metastasis. Conclusions To our knowledge, this is the first report of laparoscopic colectomy performed on an ET patient receiving anagrelide. Our report shows that complications such as bleeding or thrombosis can be avoided by anagrelide administration. Contrastingly, thrombocytopenia due to anagrelide intake should be considered when chemotherapy that could cause bone marrow suppression is administered.http://link.springer.com/article/10.1186/s40792-019-0660-3AnagrelideColorectal cancerEssential thrombocythemiaLaparoscopic surgery
spellingShingle Masaya Hiyoshi
Hiroaki Nozawa
Kentaro Inada
Takayoshi Koseki
Keiichi Nasu
Yasuji Seyama
Ikuo Wada
Koji Murono
Shigenobu Emoto
Manabu Kaneko
Kazuhito Sasaki
Yasutaka Shuno
Takeshi Nishikawa
Toshiaki Tanaka
Keisuke Hata
Kazushige Kawai
Tsuyoshi Maeshiro
Sachio Miyamoto
Soichiro Ishihara
Cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection: a case report
Surgical Case Reports
Anagrelide
Colorectal cancer
Essential thrombocythemia
Laparoscopic surgery
title Cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection: a case report
title_full Cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection: a case report
title_fullStr Cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection: a case report
title_full_unstemmed Cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection: a case report
title_short Cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection: a case report
title_sort cecal cancer with essential thrombocythemia treated by laparoscopic ileocecal resection a case report
topic Anagrelide
Colorectal cancer
Essential thrombocythemia
Laparoscopic surgery
url http://link.springer.com/article/10.1186/s40792-019-0660-3
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