Toyoda Yasuhiro, Endo Wakio, Kojima Fumiyoshi, Matsunaga Hiroki, Shimizu Kaori, Yoshioka Akiko, Fujie Yujiro, Fukunaga Hiroki, Hojo Shigeyuki, Yoshioka Setsuko, Ota Hirofumi, Terada Hiroaki, Maeura Yoshiichi
Division of Surgery, Saiseikai Senri Hospital, Japan.
Gan To Kagaku Ryoho. 2012 Nov;39(12):2420-2.
A 59-year-old woman was admitted to our hospital because of right chest pain. CT scan showed a mass on the right abdominal wall and bilateral pleural effusion. The histological diagnosis following core needle biopsy was undifferentiated sarcoma. The right pleural effusion gradually increased despite negative cytology. Although we planned chemotherapy for the clinically diagnosed pleural invasion, thrombocytopenia as a paraneoplastic syndrome appeared. The minimum thrombocyte count was 4,000/mm3. While transfusion was not effective, per os dexamethasone at 2.0 mg/day kept the thrombocyte count at around 6×10 4/mm3. Anti-thrombocyte antibody was negative. Tumor resection surgery with partial diaphragm resection and 11th and 12th rib resection, and abdominal wall plasty with mesh was performed. The final histological diagnosis was dedifferentiated liposarcoma. The thrombocyte count returned to the normal range just after the operation. However, she died of pleural dissemination, peritoneal dissemination, and local recurrence 69 days after the operation.
