A case report of gemcitabine treatment for duodenal cancer: the good (a sustained response) and the bad (life threatening refractory thrombotic thrombocytopenic purpura)

Abstract

Introduction: Adenocarcinoma of the duodenum is a rare cancer and not submitted to the type of clinical trials that guide chemotherapy treatments in other gastrointestinal malignancies.

Case report: This case demonstrates the potential use for gemcitabine, a chemotherapy typically used in pancreas and biliary tract tumors, in this difficult to treat disease as this patient had a partial response to single agent gemcitabine. Unfortunately, this case also demonstrates one of the rare potential adverse reactions to gemcitabine, which is the development of thrombotic thrombocytopenic purpura (TTP).

Conclusion: In this case, the TTP was extremely difficult to treat but was resolved with splenectomy.