Complete Response of severe idiopathic thrombocytopenic purpura after resection of bulky chromophobe renal cell carcinoma

Abstract

Idiopathic thrombocytopenic purpura (ITP) associated with renal cell carcinoma (RCC) is relatively rare. In almost all of these case reports, patients affected with ITP developed differentially-involved cancer, because resection of cancer could not improve thrombocytopenia and the treatment of ITP needed to be continued after surgery. We report the case of a 48-year-old woman with massive renal cell carcinoma, measuring approximately 20 × 14 × 14 cm, who presented with severe thrombocytopenia: platelet count, 2000 cells/µl. After confirming normal bone-marrow, she received high-dose dexamethasone and intravenous gamma globulin, which rose the platelet count to normal levels. She then underwent left radical nephrectomy. The pathological examination revealed chromophobe RCC. After the resection, the platelet count was maintained within the normal range without any treatments. The current case is the first report of chromophobe RCC causative of severe ITP and the second case who achieved a sustained complete remission of ITP after cancer surgery alone; moreover our case is only one patient without other causes of ITP.