Drug-free remission of immune thrombocytopenic purpura following resection of perihilar cholangiocarcinoma: a case report

TL;DR

A patient with a rare bile duct cancer and an autoimmune blood disorder achieved full recovery without medication after tumor removal.

Contribution

This case report shows that removing a perihilar cholangiocarcinoma tumor can lead to remission of associated immune thrombocytopenic purpura.

Findings

A 76-year-old man with pCCA and ITP achieved remission after tumor resection.

Thrombocytopenia resolved without ongoing medication after surgery.

No ITP relapse occurred following prednisolone discontinuation postoperatively.

Abstract

Immune thrombocytopenic purpura (ITP) is a rare autoimmune disorder. Although secondary ITP, caused by various underlying diseases, including some malignant tumors, has been reported, instances of ITP resolving after successful treatment of the underlying cause are uncommon and noteworthy. Herein, we present a case of a patient with perihilar cholangiocarcinoma (pCCA) and ITP who achieved drug-free remission of ITP following tumor resection. A 76-year-old man presented with pCCA complicated by ITP. Prednisolone treatment successfully managed his thrombocytopenia, allowing for a left hepatopancreatoduodenectomy. ITP relapse did not occur after discontinuation of prednisolone postoperatively. This case suggests that surgical resection of the underlying malignancy may induce remission of secondary ITP associated with pCCA.

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