Chemotherapy in a Patient with Metastatic Duodenal Cancer and Idiopathic Thrombocytopenic Purpura: A Case Report and Review of Literature

Metastatic duodenal adenocarcinoma is a rare disease, and it’s coexistence with idiopathic thrombocytopenic purpura is still very rare. Here we report first case of metastatic duodenal adenocarcinoma with coexistent ITP treated with palliative chemotherapy protocols. We initially managed ITP, after which having had a safe platelet count (above 75000/uL.), we safely administered chemotherapy protocols like FOLFOX4, FOLFIRI, XELIRI / CapeIRI. Management of idiopathic thrombocytopenic purpura was done initially by treating with steroids, and afterwards by administering intravenous immunoglobulins after which platelet count increased up to 182,000/uL. The PFS for first line chemotherapy-protocol FOLFOX4 was approximately 9 months. Presently undergoing second line palliative chemotherapy-protocol FOLFIRI/XELIRI until publishing of this manuscript. PFS for second line palliative chemotherapy and OS still not achieved.