Persistent Thrombocytosis in a Case of Pseudomyxoma Peritonea Post CRS and HIPEC -A Case Report

Abstract

Background: Cytoreductive surgery (CRS) followed by hyper thermic intraperitoneal chemotherapy (HIPEC) is an evolving treatment for peritoneal carcinomatosis (PC). Mitomycin C (MMC), an alkylating agent, is presently the most commonly used chemotherapeutic agent for hyper thermic intraperitoneal treatment. The spleen has a role in the hematologic response after HIPEC and that splenectomy may enhance hematologic toxicity profiles of MMC. We are presenting a case who developed persistent thrombocytosis After Cytoreductive surgery followed by HIPEC.Case presentation: A 48-year-old lady was referred to hematology OPD for first time with findings of persistent thrombocytosis on routine CBC follow-up. She underwent Cytoreductive surgery which include left and right parietal peritonectomy, pelvic peritonectomy, TAH+BSO, small bowel resection, right hemicolectomy, splenectomy plus heated intra operative peritoneal chemotherapy for a low-grade mucinous adenocarcinoma. Her initial platelet count was 1520x10^9/L for which she was on aspirin .Follow-up CBC showed a platelet count of 1609x10^9/L. She was investigated further and there was absence of any cause of essential thrombocytosis. Conclusion:This article to emphasize that Persistent reactive thrombocytosis can occur in a case of peritoneal carcinomatosis after CRS followed by HIPEC.