転院時に著明な血小板減少と黄疸がみられたが, 緩和ケアのみで5か月以上にわたる生存が得られた悪性線維性組織球症患者の1例

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  • Malignant Fibrous Histiocytoma Patient Who Survived for Over Five Months in Only Palliative Care Despite Marked Thrombocytopenia and Jaundice After Transferal to Our Hospital
  • ショウレイ ホウコク テンインジ ニ チョメイ ナ ケッショウバン ゲンショウ ト オウダン ガ ミラレタ ガ,カンワ ケア ノミ デ 5カゲツ イジョウ ニ ワタル セイゾン ガ エラレタ アクセイ センイセイ ソシキキュウショウ カンジャ ノ 1レイ

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  The patient was a woman in her 70s, who had been diagnosed as having a malignant fibrous histiocytoma in the right axilla with invasion to the intrathoracic space at a local hospital. The growth of cytokine-producing tumor was suspected, and thrombocytopenia caused by bleeding and jaundice by blood transfusion were disclosed. When she was admitted to our palliative care unit, the platelet count was 19,000/μl and total bilirubin was 6.4mg/dl. Furthermore, several predictive fools showed the prognosis for survival was poor. After transferal to our hospital, the patient was treated mainly with medication. No blood transfusion was given. In the clinical course, the platelet count and total bilirubin level were restored to normalcy. The patient lived on for another five months or over. The contributing factors, in prolonging her life longer than predicted were probably as follows; (1) spontaneous recovery of thrombocytopenia without bleeding, (2) improvement of jaundice caused by the blood transfusion, and (3) foods taken orally even in small amounts. There are patients whose prognosis varies substantially in the fields of the palliative care. It is important to work out proper medical treatment and care plans according to symptoms and the status of patients.

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