Treatment with perioperative high-dose γ-globulin for a case of mouth floor carcinoma associated with idiopathic thrombocytopenic purpura

A case of oral cancer at the mouth floor with idiopathic thrombocytopenic purpura is reported. A 75-year-old male visited our department complaining of a tumor of the right mouth floor. Biopsy revealed squamous cell carcinoma. The preoperative laboratory data showed a platelet count of 5.1 × 10 ⁴/μL. He was diagnosed as ITP at the Blood Medicine Department in our hospital. We planned tumor resection and right upper neck dissection. Before surgery, high-dose γ-globulin therapy (400 mg/kg/day) was performed for five days. The platelet count increased to 14.9 × 10⁴/μL after 7 days from initial γ-globulin administration. Surgery was performed successfully, and perioperative blood loss was 90 gr. After surgery, there was no abnormal bleeding, and the postoperative course was uneventful. Tumor recurrence was not observed for 1.5 years. High-dose γ-globulin therapy appears to be a safe and useful method for the surgical treatment of ITP.